Contributions of the regulatory inner core to patient safety
DOI:
https://doi.org/10.35699/2316-9389.2023.37101Keywords:
Hospital Bed Capacity, Patient Safety, Health Management, NursingAbstract
Objective: to identify the contributions of the Internal Regulation Core to patient safety. Method: qualitative research carried out between August and October 2020. Audio-recorded interviews were carried out with 13 professionals who worked in the wards, in the emergency room, in quality management and in the Internal Regulation Center. Data were analyzed using the IraMuteq® software and the steps proposed by Creswell. Results: the findings revealed that the Internal Regulation Nucleus contributes to patient safety, bypassing the established goals: effective communication; patient identification; reduction in the risk of infections associated with health care - the COVID-19 pandemic was presented as an important fact; safety for surgery, as it speeds up access to the hospital for a surgical procedure; and reduction of queues. It also helps to prevent complications resulting from falls, as the patient can be quickly allocated to a safe bed. Finally, the nurse, in his role as a leader in the service and as a link in the management of safe care, also proved to be important. Conclusion: although some weaknesses were detected, the contribution of the Internal Regulation Center stands out for strengthening patient safety goals. As a result, the importance of regulatory flows from the perspective of hospital bed management is reaffirmed, as well as the precepts of patient safety desired by managers. Nevertheless, the nurse acts as a link between these two scenarios.
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References
Richardson J. What’s really happening with hospital bed numbers? BMJ [Internet]. 2017[cited 2022 Jan 13];358:j4439. Available from: https://doi.org/10.1136/bmj.j4439
D’Aquino SF. Proposta de modelo de referência para o processo de gestão de leitos hospitalares. Florianópolis: Universidade Federal de Santa Catarina; 2017.
Ministério da Saúde (BR). Portaria nº 3390, de 30 de dezembro de 2013. Institui a Política Nacional de Atenção Hospitalar (PNHOSP) no âmbito do Sistema Único de Saúde (SUS), estabelecendo-se as diretrizes para a organização do componente hospitalar da Rede de Atenção à Saúde (RAS) [Internet]. Brasília: MS: 2013[cited 2021 Aug 10]. Available from: http://bvsms.saude.gov.br/bvs/sau delegis/gm/2013/prt3390_30_1 2_2013.html
Soares VS. Análise dos núcleos internos de regulação hospitalar de uma capital. Rev Gest Econ Saúde [Internet]. 2017[cited 2020 Feb 15];15(3):339-4. Available from: https://doi.org/10.1590/S1679-45082017GS3878
National Patient Safety Foundation (EUA). Free from harm: accelerating patient safety improvement fifteen years after To Err is Human: report of an expert panel convened [Internet]. Boston, MA: National Patient Safety Foundation; 2015[cited 2021 Aug 15]. Available from: https://psnet.ahrq.gov/issue/free-harm-accelerating-patient-safety-improvement-fifteen-years-after-err-human
Allen D. Inside ‘bed management’: ethnographic insights from the vantage point of UK hospital nurses. Sociol Health Illn [Internet]. 2015[cited 2021 Aug 15];37(3):370-84. Available from: https://pubmed.ncbi.nlm.nih.gov/25524505/
Flynn R, Newton AS, Rotter T, Hartfield D, Walton S, Fiander M, Scott SD. The sustainability of Lean in pediatric healthcare: a realist review. BMC [Internet]. 2018[cited 2020 Aug 15];7:137. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6134523/pdf/13643_2018_Article_80 0.pdf
Borges F, Bernardino E, Stegani MM, Tonini NS. Performance of nurses in the bed management service of a teaching hospital. Rev Bras Enferm [Internet]. 2020[cited 2020 Aug 15];73(4):e20190349. Available from: https://www.scielo.br/j/reben/a/qRzsNn7gmX4h4myRFDdRrtc/?format=pdf&lang=en
Ministério da Saúde (BR). Projeto Lean nas Emergências: redução das superlotações hospitalares [Internet]. Brasília: MS; 2020[cited 10 Mar 2021]. Available from: http://saude.gov.br/saude-de-a-z/projeto-lean-nas-emergencias#metodologia
Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research: a 32-item checklist for interviews and focus groups. Int J Qual Heal Care [Internet]. 2018[cited 2021 Nov 13];19(6):349-57. Available from: https://doi.org/10.1093/intqhc/ mzm042
Nascimento LCN, Souza TV, Oliveira ICS, Moraes JRMM, Aguiar RCB, Silva LF. Theoretical saturation in qualitative research: an experience report in interview with schoolchildren. Rev Bras Enferm [Internet]. 2018[cited 2020 Aug 15];71(1):228-33. Available from: https://doi.org/10.1590/0034-7167-2016-0616
Salviati ME. Manual do Aplicativo Iramuteq (versão 0.7 Alpha 2 e R Versão 3.2.3) [Internet]. Planaltina, DF; 2017[cited 2020 Nov 15]. Available from: http://www.iramuteq.org/d ocumentation/fichiers/anexo-manual-do-aplicativoiramuteq-par-maria-elisabeth-salviati
Camargo BV, Justo AM. Tutorial para uso do software de análise textual IRAMUTEQ [Internet]. Florianópolis: UFSC; 2016[cited 2016 Aug 20]. Available from: http://www.iramuteq.org/documentation/fichiers/Tutorial%20IRaMuTeQ%20em%20portugues_17.03.2016.pdf
Acauan LV, Abrantes CV, Stipp MAC, Trotte LAC, Paes GO, Queiroz ABA. Use of the IraMuteq® software for qualitative data analysis in Nursing: a reflective essay. REME - Rev Min Enferm [Internet]. 2020[cited 2021 Sept 1];24:e-1326. Available from: http://www.revenf.bvs.br/pdf/reme/v24/1415-2762-reme-24-e-1326.pdf
Creswell JW. Investigação Qualitativa: projeto de pesquisa escolhendo entre cinco abordagens. 3ª ed. São Paulo: Penso Editora, 2014.
Saleh MYN, Al-Amer R, Al Ashram SR, Dawani H, Randall S. Exploring the lived experience of Jordanian male nurses: A phenomenological study. Nurs Outlook [Internet]. 2020[cited 2021 Aug 19];68(3):313-23. Available from: https://doi.org/10.1016/j.outlook.2019.10.007
Kowalski SL, Anthony M. CE: Nursing's Evolving Role in Patient Safety. Am J Nurs [Internet]. 2017[cited 2021 May 18];117(2):34-48. Available from: https://doi.org/10.1097/01.naj.0000512274.79629.3c
Pecoraro F, Clemente F, Luzi D. The efficiency in the ordinary hospital bed management in Italy: an in-depth analysis of intensive care unit in the areas affected by COVID-19 before the outbreak. PLoSOne [Internet]. 2020[cited 2020 Aug 15];15(9):e0239249. Available from: https://doi.org/10.1371/journal.pone.0239249
Abedian S, Bitaraf E, Askari M. Advantages of a Web-Based Real-Time Bed Management System for Hospital Admission Monitoring in Iran. Stud Health Technol Inform [Internet]. 2018[cited 2020 Aug 15]; 247:536-40. Available from: https://pubmed.ncbi.nlm.nih.gov/29678018/
Hunt-O'Connor C, Moore Z, Patton D, Nugent L, Avsar P, O'Connor T. The effect of discharge planning on length of stay and readmission rates of older adults in acute hospitals: a systematic review and meta-analysis of systematic reviews. J Nurs Manag [Internet]. 2021[cited 2021 Aug 20]. Available from: https://doi.org/10.1111/jonm.13409
Alves RM. Proposta de melhoria no processo de gestão das filas cirúrgicas do Hospital Universitário de Brasília: integrando a abordagem lean healthcare e a dinâmica de sistemas [dissertação]. Brasília: Universidade de Brasília; 2018[cited 2021 Aug 15]. Available from: https://repositorio.unb.br/bitstream/1048n2/34937/1/2018_RodrigoMagalh%C3%A3esAlves.pdf
Wasgen AM, Terres MS, Machado BFH. O impacto do gerenciamento de leitos na gestão hospitalar. Rev Hospitalidade [Internet]. 2019[cited 2021 Aug 10];16(2):1-49. Available from: https://doi.org/10.21714/2179-9164.2019.v16n2.002
Oliveira AC. Nursing challenges in the face of the COVID19 pandemic. REME - Rev Min Enferm [Internet]. 2020[citado 2021 Aug 20];24:e-1302. Available from: http://reme.org.br/artigo/detalhes/1448. Available from: http://dx.doi.org/10.5935/1415-2762.20200032
Portela MC, Grabois V, Travassos C. Matriz Linha de Cuidado COVID-19 na Rede de Atenção à Saúde. Observatório COVID-19. Rio de Janeiro: Fiocruz; 2020[cited 2021 Aug 20];1-15. Available from: https://www.resbr.net.br/wp-content/uploads/2020/07/Matriz.pdf
Faria E, Costa Karl KRA, Santos MA, Fumio MK. Nova abordagem de gerenciamento de leitos associada à agenda cirúrgica. Rev Adm Saúde [Internet]. 2010[cited 2021 Aug 15];12(47):63-70. Available from: https://cqh.org.br/portal/pag/anexos/baixar.php?p_ndoc=207&p_nanexo=286
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