La comunicación de los efectos adversos en un servicio de urgencias

Abstract

Objective: to review the communication barriers in healthcare professionals when faced with an adverse event. Method: a qualitative phenomenological study conducted at the Emergency Unit from the Hospital de Tortosa Virgen de la Cinta (Tarragona) between October and December, 2018, through convenience sampling. Two focus groups were set up, with six-seven healthcare professionals grouped by time of professional experience (over or below three years). The participants were differentiated by age, gender and professional category. The Atlas.Ti program was used for analysis. Three analytical categories and 14 subcategories were identified. Results: the study included 13 professionals in two focus groups. The categories emerging from their speech were: definition of adverse event, information and improvements. The frequency of errors was normalized. They mentioned mild and severe mistakes, differentiating their action and feelings. They reported that part of their learning consists in trial-error during practice. They expressed fear to report in severe situations. The recording system is underused. They coincided in reporting as a team, after consensus, and they expressed lack of institutional protection. They proposed implementing debriefings, positive identification, communication between hospital units, information technologies, and a structured change of shift. Conclusion: fear of answers, loss of reputation, and lack of institutional support appeared as the main barriers at the time of acknowledging and reporting incidents. There was wide consensus about lack of responsibiility in communication and excuse for adverse events, and about the need to provide support and training to professionals.