Abstract
ABSTRACT Objective: to analyze the professional experience of intensive care nurses and its influence on their work activities in the continuous hemodialysis process and patient safety in the intensive care unit within the scope of the collaborative model. Method: qualitative and exploratory research, based on the systemic paradigm of patient safety, developed at the Intensive Care Unit of a private institution in the city of Rio de Janeiro, Brazil. There were 23 nurse participants who had been working for more than three months in study scenery and in direct contact with continuous hemodialysis. The data were produced from June to October of 2016 by means of observation, analyzed using thick description as well as semi-structured interviews, and then submitted to the content analysis technique. Results: were organized in two categories: the first one portrays the influence of the professional working experience on the safety of nurses' performance, which verified that in relation to continuous hemodialysis, inexperienced nurses follow guidelines and manuals, without a complete evaluation of this care situation and face difficulties in the performance of everyday care. The second category demonstrates the impact of the nurse´s inexperience on the occurrence of active errors, evidencing actions that result in the occurrence of adverse events. Conclusion: the insertion of inexperienced nurses is a latent condition in the investigated system that results in the occurrence of incidents in the continuous hemodialysis process, requiring the improvement of the collaborative model through the systematic monitoring of the performance of these professionals, such as the proposal of a safety barrier.
Highlights
IntroductionThe focus of this article is the nurse’s role in the continuous hemodialysis process in the Intensive Care Unit (ICU) regarding patient safety
The focus of this article is the nurse’s role in the continuous hemodialysis process in the Intensive Care Unit (ICU) regarding patient safety. The interest in this topic is based on the empirical observations of the researcher from her professional experience with continuous hemodialysis and patient care in the ICU under the collaborative model, in which it was realized that, as inexperienced, the domain and translation of the technological language by the ICU nurse were not effective, in some circumstances, for the resolution of practical situations related to the management of continuous hemodialysis, and could impact on patient safety
The experience of the ICU nurses in contact with this type of user leads to the acquisition of practical knowledge that leads them in the daily situations related to the operational management of the continuous hemodialysis technology
Summary
The focus of this article is the nurse’s role in the continuous hemodialysis process in the Intensive Care Unit (ICU) regarding patient safety. The interest in this topic is based on the empirical observations of the researcher from her professional experience with continuous hemodialysis and patient care in the ICU under the collaborative model, in which it was realized that, as inexperienced, the domain and translation of the technological language by the ICU nurse were not effective, in some circumstances, for the resolution of practical situations related to the management of continuous hemodialysis, and could impact on patient safety. The nurses’ performance is highlighted, whose discussion is based on: the need for specialized knowledge and training in order to conduct continuous hemodialysis; the nursing care: with the patient, the machine and the hemodialysis circuit, and focus on the prevention of complications; and the use of clinical protocols.[5,6,7,8]
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