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      Segurança do paciente na atenção primária: concepções de enfermeiras da estratégia de saúde da família Translated title: Seguridad del paciente en la atención primaria: concepciones de enfermeras de la estrategia de salud de la familia Translated title: Patient safety in primary care: conceptions of family health strategy nurses

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          Abstract

          Resumo OBJETIVOS Compreender as concepções de enfermeiras atuantes na Estratégia de Saúde da Família acerca da segurança do paciente na atenção primária em saúde e de que forma estas repercutem nas ações cotidianas dessas profissionais. MÉTODOS Estudo descritivo-exploratório de abordagem qualitativa, realizado com enfermeiras da Estratégia de Saúde da Família, em município da região central do RS. As técnicas de coleta de dados foram a entrevista semiestruturada e a observação não participante, realizadas no período de abril a novembro de 2017. Os dados foram submetidos à Análise de Conteúdo Temática. RESULTADOS A análise resultou em três categorias temáticas abordando os significados, as dificuldades e as estratégias relacionadas ao cuidado seguro. CONCLUSÕES A pesquisa mostra a necessidade de novos estudos sobre o tema. As reflexões podem contribuir para a assistência de enfermagem com vistas à segurança do paciente, qualificando tanto o trabalho das enfermeiras, como o cuidado em saúde de modo ampliado.

          Translated abstract

          Resumen OBJETIVOS Comprender las concepciones de enfermeras actuantes en la Estrategia de Salud de la Familia acerca de la seguridad del paciente en la atención primaria en salud y de qué forma éstas repercuten en las acciones cotidianas de estas profesionales. MÉTODOS Estudio descriptivo-exploratorio de abordaje cualitativo, realizado con enfermeras que trabajan en Estrategias de Salud de la Familia, en un municipio de la región central del Rio Grande do Sul. Las técnicas de recolección de datos fueron la entrevista semiestructurada y la observación sistemática no participante, realizadas en el período de abril a noviembre de 2017. Los datos fueron sometidos al Análisis de Contenido Temático. RESULTADOS El análisis de los datos resultó en tres categorías temáticas abordando el significado de seguridad del paciente, las dificultades y estrategias para el cuidado seguro. CONCLUSIONES La investigación muestra la necesidad de nuevos estudios sobre el tema. Las reflexiones pueden contribuir a la asistencia de enfermería con miras a la seguridad del paciente, calificando el trabajo de las enfermeras como del cuidado en salud de modo ampliado.

          Translated abstract

          Abstract OBJECTIVES To understand the conceptions of nurses working in the Family Health Strategy about patient safety in primary health care and how they affect the daily actions of these professional. METHODS A descriptive-exploratory study of a qualitative approach, carried out with nurses working in Family Health Strategies, in a municipality in the central region of RS. Data collection techniques were semi-structured interview and non-participant systematic observation, carried out from April to November 2017. The data were submitted to the Thematic Content Analysis. RESULTS Data analysis resulted in three thematic categories addressing the meanings, difficulties and strategies related to safe care. CONCLUSIONS The research shows the need for new studies on the subject. The reflections can contribute to nursing care with a view to patient safety, qualifying both nurses' work and health care in an expanded way.

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          As redes de atenção à saúde

          As transições demográfica e epidemiológica significam um incremento relativo das condições crônicas. Tem sido assim, no Brasil, que apresenta uma situação de saúde de tripla carga de doenças, manifestada na convivência de doenças infecciosas, parasitárias e problemas de saúde reprodutiva, causas externas e doenças crônicas. Há uma crise dos sistemas de saúde contemporâneos que se explica pela incoerência entre uma situação de saúde com predomínio relativo forte de condições crônicas e uma resposta social através de sistemas fragmentados e voltados, principalmente, para as condições agudas e as agudizações das condições crônicas. Essa crise se manifesta em nosso país, tanto no setor público quanto no setor privado. A solução para essa crise está em recompor a coerência entre a situação de tripla carga de doenças com uma resposta social estruturada em sistemas integrados de saúde: as redes de atenção à saúde. Conclui-se que há evidências na literatura internacional de que as redes de atenção à saúde podem melhorar a qualidade dos serviços, os resultados sanitários e a satisfação dos usuários e reduzir os custos dos sistemas de atenção à saúde.
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            The role of hospital managers in quality and patient safety: a systematic review

            Objectives To review the empirical literature to identify the activities, time spent and engagement of hospital managers in quality of care. Design A systematic review of the literature. Methods A search was carried out on the databases MEDLINE, PSYCHINFO, EMBASE, HMIC. The search strategy covered three facets: management, quality of care and the hospital setting comprising medical subject headings and key terms. Reviewers screened 15 447 titles/abstracts and 423 full texts were checked against inclusion criteria. Data extraction and quality assessment were performed on 19 included articles. Results The majority of studies were set in the USA and investigated Board/senior level management. The most common research designs were interviews and surveys on the perceptions of managerial quality and safety practices. Managerial activities comprised strategy, culture and data-centred activities, such as driving improvement culture and promotion of quality, strategy/goal setting and providing feedback. Significant positive associations with quality included compensation attached to quality, using quality improvement measures and having a Board quality committee. However, there is an inconsistency and inadequate employment of these conditions and actions across the sample hospitals. Conclusions There is some evidence that managers’ time spent and work can influence quality and safety clinical outcomes, processes and performance. However, there is a dearth of empirical studies, further weakened by a lack of objective outcome measures and little examination of actual actions undertaken. We present a model to summarise the conditions and activities that affect quality performance.
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              Nursing workload and patient safety - a mixed method study with an ecological restorative approach

              OBJECTIVE: The aim of this study was to analyze the potential association between nursing workload and patient safety in the medical and surgical inpatient units of a teaching hospital. METHOD: a mixed method strategy (sequential explanatory design). RESULTS: the initial quantitative stage of the study suggest that increases in the number of patients assigned to each nursing team lead to increased rates of bed-related falls, central line-associated bloodstream infections, nursing staff turnover, and absenteeism. During the subsequent qualitative stage of the research, the nursing team stressed medication administration, bed baths, and patient transport as the aspects of care that have the greatest impact on workload and pose the greatest hazards to patient, provider, and environment safety. CONCLUSIONS: The findings demonstrated significant associations between nursing workload and patient safety. We observed that nursing staff with fewer patients presented best results of care-related and management-related patient safety indicators. In addition, the tenets of ecological and restorative thinking contributed to the understanding of some of the aspects in this intricate relationship from the standpoint of nursing providers. They also promoted a participatory approach in this study.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rgenf
                Revista Gaúcha de Enfermagem
                Rev. Gaúcha Enferm.
                Universidade Federal do Rio Grande do Sul. Escola de Enfermagem (Porto Alegre, RS, Brazil )
                1983-1447
                January 2019
                : 40
                : spe
                : e20180164
                Affiliations
                [1] Santa Maria Rio Grande do Sul orgnameCentro Universitário Franciscano orgdiv1Área de Ciências da Saúde orgdiv2Mestrado em Ciências da Saúde e da Vida Brazil
                [2] Santa Maria Rio Grande do Sul orgnameUniversidade Federal de Santa Maria orgdiv1Departamento de Enfermagem orgdiv2Programa de Pós-graduação em Enfermagem Brazil
                Article
                S1983-14472019000200401
                10.1590/1983-1447.2019.20180164
                30652801
                02b9495d-9b6d-46a4-86bb-29cc01dd3e50

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 16 July 2018
                : 01 October 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 20, Pages: 0
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                SciELO Brazil

                Categories
                Artigo Original

                Seguridad del paciente,Atención primaria de salud,Enfermería,Patient safety,Primary health care,Nursing,Segurança do paciente,Atenção primária à saúde,Enfermagem

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