Abstract
This quantitative, retrospective study aimed to characterize adverse events (AE) in Intensive Care Units (ICU), Semi-Intensive Care Units (SCU) and Inpatient Units (IU), regarding nature, type, day of the week and nursing professionals / patient ratio at the moment of occurrence; as well as to identify nursing interventions after the event and AE rates. The study was performed at a private hospital in the city of São Paulo, Brazil. Two hundred twenty-nine AE were notified. The predominant events were related to nasogastric tubes (NGT) (57.6%), followed by patient fall (16.6%) and medication errors (14.8%). The nursing professionals /patient ratio at the moment of the event was 1:2 for the ICU, 1:3 for the SCU and 1:4 for the IU. A similar distribution was observed for the other days of the week. The nursing interventions were: repositioning the NGT (83.2%) and communication of the occurrence to the physician in case of medication errors (47.6%) and falls (55.2%). The highest AE rate was related to NGT.
Highlights
The focus of service quality in industries and in hospital aims to offer their clients services with total quality, free from risk and damage, providing safety and satisfaction to the client/ patient[1]
Regarding the characterization of the adverse events (AE) according to nature, the predominance of events related to the nasogastric tube (132 – 57.6%) was verified, which is in agreement with findings from other studies about AE in Intensive Care Units (ICU) and Inpatient Units, showing a higher demand for attention by the nursing team in handling and care with this device[12,13]
The distribution of nursing professionals per patient in this study shows that with a ratio of one employee for every two patients at the ICU, adverse events happened more frequently at this type of unit
Summary
The focus of service quality in industries and in hospital aims to offer their clients services with total quality, free from risk and damage, providing safety and satisfaction to the client/ patient[1]. With the objective of healthcare service quality improvement, Hospital Evaluation Programs have gained strength in the past decades. They consist of an external evaluation system that verifies the concordance of the structure and healthcare processes adopted with the set of previously established standards. In Brazil, the National Evaluation Organization (ONA) offers the Brazilian Manual of Hospital Evaluation, an instrument that works as a guideline for institutions to establish high-quality healthcare standards[5]
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