User Embracement With Risk Rating: Evaluation of the Structure, Process, and Result

Abstract

Estudo descritivo-exploratório, com abordagem quantitativa, realizado entre agosto e novembro/2011, com o objetivo de avaliar sob a ótica dos trabalhadores a estrutura, o processo e o resultado da implantação do acolhimento com classificação de risco (ACCR). Participaram 314 profissionais de quatro serviços hospitalares de emergência (SHE) de diferentes categorias profissionais. Para a coleta de dados foi usado o "Instrumento para Avaliação do Acolhimento com Classificação de Risco". Entre os sujeitos, a maioria era mulher (63,7%); da área de Enfermagem (56,7%); com experiência média de 7,2±7,6 anos no setor. Apesar de haver priorização dos casos graves; atendimento aos casos não graves; informação sobre o tempo provável de espera; e acolhimento do usuário pelos profissionais que atuam nesse sistema, constatou-se que no cômputo geral o acolhimento com classificação de risco foi avaliado como precário. Como principais agravantes detectaram-se: falta de espaço físico; problemas no relacionamento da equipe multiprofissional; e dificuldade na operacionalização das condutas estabelecidas. Concluiu-se que, apesar de nos serviços de emergência investigados as condutas fundamentais propostas pelo ACCR serem realizadas, há necessidade da operacionalização integral desse sistema.

Humanização nos serviços de urgência e emergência: contribuições para o cuidado de enfermagem

“…In this sense, the studies analyzed showed the following inadequate structural factors: lack of accommodation and chairs (27) ; limited dimensions, without refrigeration and with an unpleasant odor (28) ; lack of space to receive the accompanying person (29) ; place for storage of supplies and equipment (30) , and poor work conditions (31) . The mentioned papers make it possible to conclude that the arrangement of the physical space and adequacy of material and human resources are indispensable to ensure quality care and patient and employee safety.…”

Competências do enfermeiro nos serviços de emergência

“…Therefore, it is necessary that there is institutional support and engagement of the professionals involved in the WRC with regard to permanent education. The studies found , 2, 7,9,11,22 show permanent education as a continuous and real need in health institutions, given the weaknesses already described above. Other studies 10,20 also suggest the implementation of a training program that contemplates the development of skills including strategies to improve communication between team members, between the team and the user, and also with the family members.…”

“…23 It should be noted that, in this sense, the Federal Nursing Council 24 makes clear that, within the scope of the Nursing team, the risk classification and prioritization of care in emergency services is a private assignment of the nurse. However, studies 9,11 show that in some health services, this activity is performed by a mid-level professional, revealing the need to reformulate the staffing dimension and to rectify the responsibilities of each member of the multi-professional team so that the service becomes more efficient and effective prevention of damages and damages resulting from malpractice.…”

“…It is understood that the nurse is responsible for the risk classification procedure, however, it is important to highlight the need for all professionals involved in the WRC to develop reception actions. 9 The nurse cannot assume for himself any responsibility of the process that, in order to guarantee the quality and humanization of assistance in the WRC, needs the proper functioning of the referral flows between the services. This can generate professional dissatisfaction with the results of the WRC, which are sometimes linked to issues that do not depend exclusively on the worker.…”

“…This can generate professional dissatisfaction with the results of the WRC, which are sometimes linked to issues that do not depend exclusively on the worker. 10 Among these issues, we highlight the need for greater institutional support regarding, for example, the physical structure in which evaluation research 9 shows the inadequacy of English/Portuguese J Nurs UFPE online., Recife, 12(10):2816-24, Oct., 2018 2822 the physical plant for patients and professionals. Other organizational weaknesses already identified are the qualitative and quantitative lack of human resources; the precariousness or lack of equipment and materials, and the fragility of the referral and counter-referral system that undoubtedly undermines the service process in the WRC.…”