Patient safety incidents reported by relatives of hospitalized children

Abstract

Objective: To know the main safety incidents reported by relatives of patients hospitalized in pediatric units. Methods: This is a qualitative research with exploratory-descriptive design. Data were collected between April 2016 and December 2017, in three hospitals in Porto Alegre/RS. A total of 91 semi-structured interviews were conducted with relatives of pediatric patients hospitalized in emergencies, infirmaries, and intensive care centers. The statements were transcribed in full and submitted to a thematic content analysis. Results: The category Identification of safety incidents by relatives of hospitalized pediatric patients was formulated. Eight subtopics emerged: drug therapy, hand and environment hygiene, diet therapy, risk of falls, communication, patient identification, care processes/procedures and access to the institution. Conclusions: The family identified safety incidents in various stages of care for hospitalized children. It is necessary to think about strategies that integrate the family in the care of children, to minimize risks and complications resulting from care.

Involvement of companions in patient safety in pediatric and neonatal units: scope review

“…The companions also mentioned the importance of recognizing risk situations for AEs, especially in relation to medication errors, patient identification (26)(27)(30)(31) and care procedures (27,(30)(31)(32) . Among the incidents recognized by companions, there are delays in administration, poor communication related to therapy, mistake in drug suspension, infusion time and incorrect dosages, and lack of an allergy bracelet (27) .…”

“…• Receive explanations about the rules and procedures offered by the team (30) ; • Having clear communication with the health team (30) ; • Receive information about risks, complications and procedures performed (30) ; • Receive support and attention from the team when identifying risks for adverse events (30) ; • Trust professionals (29)(30) ; • Be aware of the responsibility of companions in monitoring the care provided to their children (29,31) ; • Enable companions to identify risks and adverse events (26)(27)(30)(31)(32) .…”

“…• Realize that there are difficulties in reporting patient safety incidents in a form or computerized system (23) ; • Ineffective communication between all those involved in child care (23,27,29,32) ; • Lack of sufficient materials and equipment, as well as the precariousness of the hospital structure (26) ; • Impact of the Neonatal Intensive Care Unit environment on the bonding process between the child and companions (29) ; • Lack of knowledge of how to help prevent health risks (30) ; • Unfamiliarity of the patient/companion's rights and duties (30) ; • Companions feel excluded from the child's treatment, diagnosis and prognosis, becoming more anxious and insecure (34) ; • Unfamiliarity about the term patient safety (31) .…”

“…• Games and playful activities that address the subject of patient safety (25) ; • Effective communication between everyone involved in child care (23,32) ; • Adoption of practices against adverse events with the participation of companions (26,29,31) ; • Professional qualification through continuing education and encouraging research in the area of patient safety (31,34) .…”

“…To enable the companion's involvement in the child's safety, it is necessary for professionals to improve the instrumentation of caregivers through education and in the documentation of records in medical records (39) . Other AEs identified by companions were risk of infections (26)(27)30,32) , phlebitis (30) , falls or risk of falling (26,27,(30)(31) , pressure injury (30) , lack of control of access to the unit (27,32) , failures in the unit's routine and team dynamics (32) , errors in the diet offered to patients (26)(27) and unidentified isolation beds (26) . These situations reinforce the importance of involving companions as partners in the prevention of AE and, consequently, of PS (23) .…”