Eventos adversos relacionados às práticas assistenciais: uma revisão integrativa

Figueiredo, Mirela Lopes de; D’Innocenzo, Maria

doi:10.6018/eglobal.16.3.256091

Cited by 15 publications

(18 citation statements)

References 22 publications

(44 reference statements)

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“…22 Most of the ME notifications were done by Nursing professionals, who are directly involved in the process of medication administration. 23 As regards the severity of the medication errors, it was found that 82% of the errors reached the patients without causing them any harm and that only 5% of the patients required monitoring, results which are close to those obtained in a study conducted in 2014 with values nearing 70% of MEs that reached the patients; 24 in another case, the results show that 42% of the errors reached the patients but without causing them any harm. 25 We highlight that one of the limitations of this study refers to the sample size, since 50 reports of adverse events associated with medication errors were found, which contribute scarce information about both the origin and analysis of the events.…”

Section: /13supporting

confidence: 72%

Risk Factors in Medication Errors in a High-Complexity Chilean Public Hospital

Cárcamo

Tourinho

Alves

2020

Texto contexto - enferm.

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Objective: to identify the risk factors in medication errors in a high-complexity chilean public hospital. Method: a research study with a quantitative approach; an exploratory, descriptive and cross-sectional study, with retrospective temporal cuts. The study population consisted of 50 reports of adverse events related with the medication administration process generated between 2014 and 2017 in the Medical and Surgery services of the Magallanes Clinical Hospital, Chile. The classification of the National Coordinating Council for Medication Error Reporting and Prevention was used for data collecting, performed during May and June 2018, and the data were analyzed by means of descriptive statistics. Results: among those involved in the medication errors, the following professions are predominant: nurses, 21 (42%); Medical and Surgery nursing technicians, 18 (36%), and nursing technicians working in the Pharmacy, 7 (14%). The most frequent medication errors were the following: medication transcription, 16 (32%); preparation, 13 (26%); and administration, 11 (22%). The following risk factors stand out in the notified cases: communication and interpretation problems, 13 (26%); incorrect interpretation of the prescription at dispensation, 7 (14%); factors associated with work organization such as insufficient compliance with the priority safety practices, 11 (22%), and individual factors, 9 (18%). Conclusion: more information is required about medication errors to identify the risk factors and to establish strategies for their prevention; consequently, the notification of adverse events must be promoted as a preventive measure.

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Section: /13supporting

confidence: 72%

Risk Factors in Medication Errors in a High-Complexity Chilean Public Hospital

Cárcamo

Tourinho

Alves

2020

Texto contexto - enferm.

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“…1 Through epidemiological studies, the high incidence of human error-caused adverse events that is frequently demonstrated indicated the need to reconsider and modify the care models, linking them up with the countless global campaigns, programs and projects that guide health team actions. 2 The way healthcare errors are interpreted and acted upon maintains the understanding of punitive or hidden postures. Changing this scenario rests on the health managers' understanding of the error as necessary.…”

Section: Introductionmentioning

confidence: 99%

“…Identifying the potentials and weaknesses of the health teams towards adverse events is essential, facilitating the adoption of preventive measures and trust among the professionals. 2 Adverse event reporting is part of health care management and, therefore, part of the responsibilities to manage and help the nurses. Setting up a reporting system allows the professionals to share responsibilities and develop actions that are integrated with the logic of continuing and continuing in-service education.…”

Section: Introductionmentioning

confidence: 99%

“…Setting up a reporting system allows the professionals to share responsibilities and develop actions that are integrated with the logic of continuing and continuing in-service education. 2 In a study aimed at identifying the relation between how many patients a nurse provides care to and the occurrence of adverse events, 3 the findings showed that a larger number of patients per nurse increases the incidence of adverse events. In the same study, it was identified that bad working environments also favor this increase.…”

Section: Introductionmentioning

confidence: 99%

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Nursing Professionals and Adverse Event Reporting

Maldonado

Nascimento

Lazzari

2020

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Objective: to identify how nurses report adverse events; to know what elements influence adverse event reporting and which reporting strategies they suggest. Method: qualitative study with a convergent care research design, conducted in a critical patient unit of a private health center in the region of Magallanes, Chile. Thirteen nurses participate in the study, through interviews and a discussion group. Results: the nurses who report adverse events do so verbally and in writing to the nurse coordinator immediately. Failure to report adverse events is mainly due to lack of knowledge of the safety culture, fear of reprisals and punishment within the workplace. As adverse event reporting strategies, they suggest continuing education about the safety culture, raising awareness and trust in that error reporting will not be met with punishment and that the error will lead to an improvement plan that avoids committing the same error on another occasion, improving communication and leadership. Conclusion: although nurses report adverse events, they are concerned with punishment, indicating the need to review the patient safety culture at a critical care unit in the study context.

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“…La seguridad del paciente ha sido un tema de estudio en los sistemas de salud, que ha surgido como respuesta a los múltiples eventos adversos que sufren las personas en los centros hospitalarios, situación que se expuso en el año 2000 con la publicación del libro "To Err is Human" (1,2) , el cual cita que los errores médicos producen entre 44.000 y 98.000 muertes al año en Estados Unidos, cifra que supera las muertes ocasionadas por accidentes automovilísticos. Esta situación llevó a la Organización Mundial de la Salud (OMS) a crear un grupo de trabajo para evaluar la seguridad del paciente en los servicios de salud (3) .…”

Section: Introductionunclassified

Errores de medicación en pacientes hospitalizados: una revisión sistemática

et al. 2021

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Objetivo: Describir los errores de la medicación y sus factores asociados, así como evaluar la calidad metodológica de los estudios disponibles. Método: Se realizó una revisión sistemática de la literatura en las bases de datos PubMed, Scielo, LILACS, Ebsco. Medes, Sietes, Dialnet y Science Direct, teniendo en cuenta las referencias bibliográficas encontradas entre 2010 y 2020, entre los meses de mayo y abril de 2020, utilizando la ecuación de búsqueda Errores de medicación and Pacientes AND Hospitalización, y sus equivalentes en inglés y portugués. Se seleccionaron los estudios a través de un cribado que inició con la lectura de títulos, resumen y texto completo y se realizó la valoración de la calidad metodológica y riesgo de sesgo de los estudios mediante la lectura crítica con la guía Ciapponi. Resultados: Se incluyeron en la revisión 23 artículos, 43,4% transversales y 39% prospectivos. Se evidenció que los errores de medicación se presentan en las diferentes etapas del proceso de atención del paciente, siendo más frecuentes en la etapa de prescripción y administración del mismo. Estos errores se asociaron a la sobrecarga laboral, el número de medicamentos recibidos, las enfermedades complejas de los pacientes, estancias hospitalarias prolongadas, medicación intravenosa y distracción. Conclusiones: Los errores están presentes en los procesos de medicación, principalmente en las fases de prescripción y medicación de los medicamentos, asociados en mayor medida a la sobrecarga laboral, el número de medicamentos y la presencia de enfermedades complejas.

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Eventos adversos relacionados às práticas assistenciais: uma revisão integrativa

Cited by 15 publications

References 22 publications

Risk Factors in Medication Errors in a High-Complexity Chilean Public Hospital

Risk Factors in Medication Errors in a High-Complexity Chilean Public Hospital

Nursing Professionals and Adverse Event Reporting

Errores de medicación en pacientes hospitalizados: una revisión sistemática

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