Efetividade de uma intervenção educativa para promoção da cultura de notificação de incidentes em saúde
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Data
2018-09-14
Autores
Melgarejo, Celsa Raquel Villaverde [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Estima-se que a notificação espontânea de incidentes capture apenas 10% dos eventos ocorridos em instituições hospitalares. Entretanto, a educação em saúde pode contribuir para o estímulo do aumento do índice de notificações assim como para a segurança do paciente. Diante disso, o objetivo do estudo foi avaliar a efetividade de uma Intervenção Educativa (IE) para promoção da notificação de incidentes em saúde para profissionais de um hospital de ensino no interior do estado de São Paulo. O estudo foi do tipo experimental, aberto, não randomizado e houve adaptação da IE através de um pré-treinamento com alunos de graduação da Faculdade de Ciências Farmacêuticas da Unesp. Os profissionais incluídos no estudo foram aqueles cuja atuação fosse da área assistencial. Foram excluídos, profissionais afastados por um período maior do que três meses, estagiários e residentes. A participação dos profissionais na IE foi feita através da alocação por conveniência, com formação de três turmas, de acordo com turno de trabalho dos participantes. A IE foi realizada durante três meses, por meio de aulas expositivas, divididas em quatro módulos com duração de 60 minutos cada, realizados em dias alternados por duas semanas, além da aplicação de questionário antes e depois. As variáveis analisadas estavam relacionadas ao conhecimento, habilidade e atitude em notificação. As respostas dos questionários, assim como a quantidade e qualidade dos itens preenchidos na ficha de notificação foram avaliadas por meio de comparação antes e depois da IE, de acordo com resposta padrão estabelecida (OMS, Anvisa), bem como o número absoluto de notificações realizadas pelos profissionais nos dois momentos. Foram atribuídos conceitos e notas de zero a dez pontos a partir dos acertos obtidos nos questionários e o preenchimento dos itens da ficha de notificação. Os testes estatísticos empregados para avaliação de conhecimento em notificação foram o t-student e Wilcoxon para amostras pareadas, e para habilidade e atitude foram aplicados o teste ANOVA para amostras repetidas. Houve baixa adesão dos profissionais na IE (27,8%; 99/356). O estudo foi registrado na plataforma do Ministério da Saúde, REBEC, cujo identificador é RBR-6bxq36. Apesar da efetividade da intervenção para a aquisição de conhecimento (p=0,0001), não houve o mesmo resultado para habilidade e atitude (p>0,05), embora tenha sido observada tendência de melhora no relato de alguns incidentes, assim como tendência de aumento na taxa de incidência de notificação. Nessa perspectiva, a conclusão do estudo permite inferir que a efetividade da IE foi apenas para o conhecimento da notificação de incidentes em saúde.
It is estimated that spontaneous incident reporting captures only 10% of events occurring in hospitals. However, health education can contribute to the stimulation of the increase of the index of notifications as well as to the safety of the patient. Therefore, the objective of the study was to evaluate the effectiveness of an Educational Intervention (IE) to promote the notification of health incidents for professionals of a teaching hospital in the interior of the state of São Paulo. The study was an open-label, non-randomized trial, with an adaptation of IE through pre-training with undergraduate students from the Faculty of Pharmaceutical Sciences of Unesp. The professionals included in the study were those whose work was in the care area. Excluded professionals for more than three months, trainees and residents were excluded. The participation of the professionals in IE was made through the allocation for convenience, with formation of three classes, according to the work shift of the participants. EI was carried out during three months, through lectures, divided into four modules lasting 60 minutes each, held on alternate days for two weeks, in addition to the application of a questionnaire before and after. The analyzed variables were related to the knowledge, ability and attitude in notification. The responses of the questionnaires, as well as the quantity and quality of the items filled in the notification form were evaluated by means of a comparison before and after the IE, according to the established standard response (WHO, Anvisa), as well as the absolute number of notifications made by the professionals in the two moments. Concepts and grades were assigned from zero to ten points based on the answers obtained in the questionnaires and the completion of the items in the notification form. The statistical tests used for the evaluation of knowledge in the notification were t-student and Wilcoxon for paired samples, and the ANOVA test for repeated samples was applied for skill and attitude. There was low adherence of professionals in IE (27.8%, 99/356). The study was registered in the Ministry of Health platform, REBEC, whose identifier is RBR-6bxq36. Despite the effectiveness of the intervention for the acquisition of knowledge (p = 0.0001), there was not the same result for skill and attitude (p> 0.05), although there was a trend of improvement in reporting some incidents, as well as increase in the incidence rate of notification. In this perspective, the conclusion of the study allows to infer that the effectiveness of IE was only for the knowledge of the notification of health incidents.
It is estimated that spontaneous incident reporting captures only 10% of events occurring in hospitals. However, health education can contribute to the stimulation of the increase of the index of notifications as well as to the safety of the patient. Therefore, the objective of the study was to evaluate the effectiveness of an Educational Intervention (IE) to promote the notification of health incidents for professionals of a teaching hospital in the interior of the state of São Paulo. The study was an open-label, non-randomized trial, with an adaptation of IE through pre-training with undergraduate students from the Faculty of Pharmaceutical Sciences of Unesp. The professionals included in the study were those whose work was in the care area. Excluded professionals for more than three months, trainees and residents were excluded. The participation of the professionals in IE was made through the allocation for convenience, with formation of three classes, according to the work shift of the participants. EI was carried out during three months, through lectures, divided into four modules lasting 60 minutes each, held on alternate days for two weeks, in addition to the application of a questionnaire before and after. The analyzed variables were related to the knowledge, ability and attitude in notification. The responses of the questionnaires, as well as the quantity and quality of the items filled in the notification form were evaluated by means of a comparison before and after the IE, according to the established standard response (WHO, Anvisa), as well as the absolute number of notifications made by the professionals in the two moments. Concepts and grades were assigned from zero to ten points based on the answers obtained in the questionnaires and the completion of the items in the notification form. The statistical tests used for the evaluation of knowledge in the notification were t-student and Wilcoxon for paired samples, and the ANOVA test for repeated samples was applied for skill and attitude. There was low adherence of professionals in IE (27.8%, 99/356). The study was registered in the Ministry of Health platform, REBEC, whose identifier is RBR-6bxq36. Despite the effectiveness of the intervention for the acquisition of knowledge (p = 0.0001), there was not the same result for skill and attitude (p> 0.05), although there was a trend of improvement in reporting some incidents, as well as increase in the incidence rate of notification. In this perspective, the conclusion of the study allows to infer that the effectiveness of IE was only for the knowledge of the notification of health incidents.
Descrição
Palavras-chave
Notificação, Erros médicos, Educação continuada, Gestão de riscos, Dano ao paciente, Risk management, Patient harm, Continuing education, Medical errors