Patient experience in co-production of care: perceptions about patient safety protocols

Abstract

Objective: to analyze the experience of the patient during hospitalization, focusing on the co-production of care related to patient safety protocols. Method: qualitative study, whose data were collected through the triangulation of multiple sources: document analysis, observation of 10 professionals in the provision of care and 24 interviews with patient-families from 12 clinical and surgical inpatient units of a hospital. Thematic analysis was carried out, based on the concept of co-production. Results: safety protocols according to the experience of the patient portrayed the role of patient-families as co-producers of safe care. It was found an alignment between perceptions of the patients, institutional definitions and basic national and international patient safety protocols. However, these protocols are not always followed by professionals. Conclusion: co-production was perceived in the protocols for safe surgery and prevention of injuries resulting from falls. In patient identification, hand hygiene and medication process, it was found that co-production depends on the proactive behavior of patient-families, as it is not encouraged by professionals. The research contributes with subsidies to leverage the participation of the patient as an agent of their safety, highlighting the co-production of health care as a valuable resource for advancing patient safety.

Modeling of adult patient falls and the repercussions to Nursing as a second victim

“…These are facts evidenced by the professionals when they identify the importance of the qualification of the teams, of the education of patients and companions, making them partners in care (21) . It is from this perspective that resilient systems are needed as a way to reduce this variability and provide greater support to professionals.…”

“…The implementation of collaborative practices qualifies health services to the extent that there is understanding of the dimension of the work involved, resulting in better outcomes, patient safety, and promoting relationships of trust among professionals. In this context, this collaborative practice must reflect the joint construction and, therefore, it is necessary to rethink the activity performed, in addition to criticize and act, but to think, plan and replan the work focused on the care that will be offered to the patient, investing in the multidisciplinary team, aiming to reduce falls, an occurrence that interferes with the continuity of care and patient safety (21)(22)24) .…”

Modelagem de quedas de pacientes adultos e as repercussões à Enfermagem como segunda vítima

“…na vigência de mudança no estado geral do paciente, pela impossibilidade da equipe de Enfermagem em acompanhar o paciente durante seus deslocamentos, bem como por uma necessidade de investimento, quer no paciente e seu familiar, quer nas equipes que gerenciam os cuidados e a condução desse paciente. Esses são fatos evidenciados pelos profissionais quando identificam a importância da qualificação das equipes, de educação dos pacientes e acompanhantes, tornando-os parceiros do cuidado (21) . É sob essa perspectiva que se fazem necessários sistemas resilientes como forma de reduzir essa variabilidade e propiciar um maior suporte aos profissionais.…”

“…Nesse contexto, essa prática colaborativa deve refletir a construção conjunta e, para tanto, é preciso repensar acerca da atividade realizada, para além de criticar e agir, mas pensar, planejar e replanejar o trabalho com foco no cuidado que será oferecido ao paciente, investindo na equipe multidisciplinar, visando à redução das quedas, ocorrência que interfere na continuidade do cuidado e na segurança do paciente (21)(22)24) . (25) .…”

Modelaje de caídas de pacientes adultos y las repercusiones en la Enfermería como segunda víctima

“…Además de eso, en la vigencia de cambios en el estado general del paciente, por la imposibilidad, del equipo de Enfermería, de acompañar al paciente durante sus desplazamientos, así como por una necesidad de hacer inversiones en el paciente y su familiar o en los equipos que administran los cuidados y la conducción de ese paciente. Esos son hechos evidenciados por los profesionales cuando identifican la importancia de la calificación de los equipos, de la educación de los pacientes y acompañantes, transformándolos en aliados del cuidado (21) . Bajo esta perspectiva son necesarios sistemas resilientes como forma de reducir esa variabilidad y propiciar un mayor soporte a los profesionales.…”