Indicators of health and safety among institutionalized older adults.

Maria Lígia Silva Nunes Cavalcante,Cíntia Lira Borges,Acácia Maria Figueiredo Torres De Melo Moura Moura,Rhanna Emanuela Fontenele Lima De Carvalho

doi:10.1590/s0080-623420160000500009

Abstract

To identify the incidence of mortality, diarrheal diseases, scabies and falls; and the prevalence of pressure ulcers - all of which are related to the safety ofinstitutionalized older adults. This was a documentary retrospective study developed in a long-term residential careinstitution for older adults in the Northeast region of Brazil. The data were gathered from records of health assessment indicators filed between January 2008 and December 2015. Analysis included absolute case frequency; the sum of monthly prevalence and incidence rates; mean values of cases; and mean annual incidence and prevalence rates. The incidence of mortality over these nine years ranged from 9% to 13%; of acute diarrheic disease from 13% to 45%; and scabies from 21% to 63%. The prevalence of pressure ulcers ranged from 8% to 23%. Between 2012 and 2015, the incidence rate of falls without injury varied from 38% to 83%, and with injury from12% to 20%. Analysis of the health indicators revealeda high incidence of scabies and falls and a high prevalence of pressure ulcers. The identification of less than optimal rates for performance indicators canhelp improve the quality of nursing care. Identificar a incidência de mortalidade, doenças diarreicas, escabiose e quedas, e a prevalência de lesões por pressão para a segurança do idoso institucionalizado. Estudo documental, retrospectivo desenvolvido em uma Instituição de Longa Permanência para Idosos, localizada no nordeste do Brasil. Os dados foram coletados por meio dos registros dos indicadores de avaliação de saúde, arquivados de janeiro de 2008 a dezembro de 2015. A análise incluiu a frequência absoluta dos casos; o somatório das taxas de prevalência e incidência mensais; a média de casos e das taxas de incidência e prevalência anuais. Observa-se que a incidência de óbitos nos nove anos considerados variou de 9 a 13%; de doenças diarreicas agudas, de 13 a 45%; e de escabiose, de 21 a 63%. A prevalência de lesão por pressão oscilou de 8 a 23%. Entre os anos de 2012 a 2015, a taxa de incidência de quedas sem lesão variou em torno de 38 a 83%, e com lesão, de 12 a 20%. A análise da amplitude dos indicadores de saúde permitiu identificar a alta incidência de escabiose e de quedas e a elevada prevalência de lesões por pressão. A identificação do comprometimento dos indicadores contribui para otimização da qualidade da assistência de enfermagem.

Highlights

The promotion of patient safety has gained global attention in recent years, being considered an essential strategy for healthcare quality[1]
Patient safety depends on both the characteristics of the institutional system, in terms of structures and processes, and the conditions of health professionals, such as adequacy of training and education, workload, and communication, all of which are crucial aspects that influence the occurrence of adverse events[2]
Safe care must be valued as a patient right and must be part of the ethical commitment of professionals throughout the entire healthcare network. Among such services, hospitals tend to be the main targets of patient safety actions, to the detriment of primary healthcare units, home care services, psychosocial support centers and long-term residential care institutions for older adults

Summary

Introduction

The promotion of patient safety has gained global attention in recent years, being considered an essential strategy for healthcare quality[1]. Patient safety depends on both the characteristics of the institutional system, in terms of structures and processes, and the conditions of health professionals, such as adequacy of training and education, workload, and communication, all of which are crucial aspects that influence the occurrence of adverse events[2]. Safe care must be valued as a patient right and must be part of the ethical commitment of professionals throughout the entire healthcare network. Among such services, hospitals tend to be the main targets of patient safety actions, to the detriment of primary healthcare units, home care services, psychosocial support centers and long-term residential care institutions for older adults. Special mention goes to the creation of safety indicators that serve as a basis for controlling healthcarerelated adverse events[3]

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Conclusion