Abstract
An integrative review was performed to identify and analyze national studies on barriers to patient safety incident reporting by health professionals within Brazilian health services. A search in the Virtual Health Library (BVS) Portal, PubMed and Web of Science was performed in January 2017 for papers published in the last ten years. One thousand and seven publications were identified and, following application of inclusion and exclusion criteria, eight papers were analyzed, five of which were qualitative and three quantitative. All research was conducted in hospitals, exclusively with nursing professionals, and 75% was conducted in Southeast Brazil. Most studies showed an under-reporting of incidents, and the main reasons were fear about reporting, reporting focused on more severe incidents, lack of knowledge about the subject or how to report and, registered nurse-centered reporting. While study of this theme is still incipient in Brazil, this review found important weaknesses in the process and barriers to incident reporting by professionals, revealing a need for encouraging their participation, eliminating or reducing such barriers with a view to strengthening patient safety.
Highlights
Resumo Realizou-se revisão integrativa que objetivou identificar e analisar publicações nacionais sobre motivos para a não notificação de incidentes de segurança do paciente por profissionais no contexto dos serviços de saúde brasileiros
Embora o estudo desta temática seja incipiente no Brasil, a presente revisão encontrou importantes fragilidades e motivos apontados pelos profissionais para a não notificação de incidentes, revelando a necessidade de incentivar sua participação, eliminando ou reduzindo barreiras, com o objetivo de fortalecer a segurança dos pacientes
Atualmente, sabe-se que ocorrência de eventos adversos (EA) tem como principais fatores contribuintes as falhas e fragilidades no sistema e processos de assistência à saúde[7,8], que precisam ser melhorados
Summary
Foram identificadas 1007 publicações nas bases de dados eletrônicas, incluindo as duplicações e, após leitura dos títulos, resumos e exclusão das Tabela 1. BVS (((“incident#” OR err# OR “adverse event#” OR “patient safety” OR “segurança do paciente” OR “evento adverso” OR “eventos adversos” OR “err#”) AND (notifica# OR registro OR comunic# OR communic# OR inform# OR report# OR subnotificação OR underreport# OR underreport# OR “gerenciamento de risco” OR “risk management”))) AND País de afiliação: Brasil. Pubmed ((“adverse events” OR “adverse event” OR “incident” OR error OR “Medication Errors”[Mesh]) AND (report OR reporting OR notification OR underreporting OR under-reporting OR “incident reporting system” OR “incident reporting” OR “communication”[MeSH Terms] OR “communication”)) AND ((“brazil”[MeSH Terms] OR “brazil” OR brazilian OR brasil)). Web of ((“adverse events” OR “adverse event” OR “incident” OR error OR Science “Medication Errors”) AND (report OR reporting OR notification OR underreporting OR under-reporting OR “incident reporting system” OR “incident reporting” OR “communication”)) AND ((“brazil”OR “brazil” OR brazilian OR brasil)).
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