Дисертації з теми "Safety Team"
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Ballangrud, Randi. "Building patient safety in intensive care nursing : Patient safety culture, team performance and simulation-based training." Doctoral thesis, Karlstads universitet, Institutionen för hälsovetenskaper, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-29870.
Повний текст джерелаBaksidestext Intensive care represents potential patient safety challenges for critically ill patients. Human errors are the most common cause of incidents, and failures in team performance are identified as contributory factors. The measurements of patient safety culture and simulation-based team training are recommended initiatives to improve patient safety. The aim of the thesis was to investigate patient safety culture, team performance and the use of simulation-based team training for building patient safety in intensive care nursing. The nurses had a positive perception of the overall patient safety culture. A potential for improvements were found in incident reporting, feedback and communication about errors and organizational learning. The RNs evaluated the simulation-based team training programme in a positive way. The assessments of nurses’ team performance with respect to communication, leadership and decision-making in a simulation-based emergency situation showed a variation in competencies from advanced novice to competent. There were differences between expert raters’ assessments and nurses’ self-assessments. The nurses perceived that simulation-based team training on a regular basis increases the awareness of clinical practice and acknowledges the importance of structured teamwork.
Zagarese, Vivian. "Leadership During Action Team Formation: The Influence of Shared Leadership Among Team Members During the Perioperative Process." Thesis, Virginia Tech, 2020. http://hdl.handle.net/10919/100875.
Повний текст джерелаM.S.
In the field of Industrial and Organizational Psychology, many leadership theories have been developed, however, there is a lack of understanding as to which type of leadership is best for teams who work in high-stress environments, such as the operating room. This study looks at two types of leadership: shared leadership and autocratic leadership. Shared leadership is when all team members emerge and have a leadership role, whereas autocratic leadership is when one person makes all the decisions without consulting other team members. Previous research has articulated leadership behaviors, but has largely ignored the temporal processes of leadership, and how it changes over time throughout the surgical procedure. This study builds upon other studies by testing how leadership behaviors are related to levels of psychological safety and the optimization of teamwork and communication among team members. We were also interested in understanding if the surgeon’s perception of past performance of their team has an impact on the amount of trust the leader has in his/her team and if this in turn, has an impact on the type of leadership utilized during the team’s tenure. As an exemplar environment, we explored these dynamics in the operating theater, which is a high stakes environment requiring both technical and non-technical skills, such as leadership, communication, and teamwork. Results show that the relationship between the surgeon’s perceived past performance of the team and the trust the surgeon has in his/her team is significant and the relationship between the trust the surgical team members have in each other and the amount that they communicate with each other is also significant.
Young, Stephen Mark. "Attitude change following a team-based intervention to improve industrial safety." Thesis, University of Liverpool, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.298699.
Повний текст джерелаD'Esmond, Lynn Berggren Knapp. "Distracted Practice and Patient Safety: The Healthcare Team Experience: A Dissertation." eScholarship@UMMS, 2016. https://escholarship.umassmed.edu/gsn_diss/41.
Повний текст джерелаClack, Katinka. "Empowering leadership and safety behaviour in extreme work environments." Diss., University of Pretoria, 2017. http://hdl.handle.net/2263/62690.
Повний текст джерелаDissertation (MCom)--University of Pretoria, 2017.
Human Resource Management
MCom
Unrestricted
Walker, Raquel Maria. "Improving Perinatal Team Communication to Decrease Patient Harm With Team Strategies and Tools to Enhance Performance and Patient Safety Training." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3265.
Повний текст джерелаSpitulnik, Jay J. "Physician Collaboration and Improving Health Care Team Patient Safety Culture: A Quantitative Approach." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6486.
Повний текст джерелаGregg, Lisa. "Collaboration in family violence intervention: A process evaluation of the hamilton Family Safety Team." The University of Waikato, 2007. http://hdl.handle.net/10289/2520.
Повний текст джерелаLeak, Michelle A. "Teaming Up for Patient Safety| A Case Study of Social Interactions among Surgical Team Members." Thesis, The George Washington University, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3688016.
Повний текст джерелаDespite increased awareness of the link between teamwork and medical errors, and increased development of interventions aimed at improving team performance, the incidence of preventable errors in hospitals, and in the surgical environment particularly, remains high. Absent from interdisciplinary team development efforts is empirical evidence informed by the voices of surgical team members specific to their day- to- day experiences of teamwork. For this reason, a case study of interdisciplinary teamwork among Orthopedic Surgery team members was conducted from June to December 2013 to: (a) discover how teamwork behaviors are enacted in the surgical environment to affect the incidence of preventable surgical errors; and (b) understand the experience of teamwork from the perspective of surgical team members.
The case study data included 37 one-on-one interviews with Orthopedic Surgery team members (including two supervisors), and observations by the researcher guided by the Observational Teamwork Assessment for Surgery (OTAS) instrument. This study finds that while mindfulness is a prerequisite to safety behaviors that are found in the surgical setting, there is a dynamic interplay between processes of collective mindfulness and traditional teamwork behaviors wherein one continuously informs, shapes, and reinforces the other. Noting contributions of the this study to practice, the opportunity exists to expand the present inquiry beyond Orthopedic Surgery to include other surgical specialties as well as non-surgical practices within the hospital and clinic environments.
Chitwood, Tara Marshall. "SECOND VICTIM: SUPPORT FOR THE HEALTHCARE TEAM." Case Western Reserve University Doctor of Nursing Practice / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=casednp1554820138107259.
Повний текст джерелаBunch, Jacinda Lea. "Rapid response systems : evaluation of program context, mechanism, and outcome factors." Diss., University of Iowa, 2014. https://ir.uiowa.edu/etd/1558.
Повний текст джерелаBjörk, Jessica, and Alina Lindholm. "Att respektera varandras kompetenser : Sjuksköterskors erfarenheter av att arbeta i interprofessionella team." Thesis, Högskolan i Halmstad, Akademin för hälsa och välfärd, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-28212.
Повний текст джерелаIn the healthcare sector, interprofessional collaboration has proven to enhance patient safety. Nurses are often a part of interprofessional teams and collaboration is one of the core competencies of nurses. Knowledge about what affects collaboration is needed to fulfill this core competence. The purpose was therefore to illustrate nurses experiences of interprofessional collaboration. The study was conducted as a literature review of nursing research. The literature review was based on 13 scientific articles whos results were analyzed with guidance from a qualitative content analysis and four categories of nurses experiences arose from the analysis. These categories were to respect each others competences, to have a clear job allocation, to work with different personalities and to work towards a common goal. According to nurses experiences, clinical competence, social competence, respect, communication, trust, education, understanding of roles and common goals were essential for succesfull collaboration. To prepare nursing students for interprofessional collaboration, theoretical and practical education with other healthcare students are suggested. Education for staff already working in the healthcare sector is also believed to be valuable. To enhace nurses competence in collaboration, further research of nurses experiences of interprofessional collaboration is necessary.
Ekström, Ellen. "Using Shared Priorities to Support Training of Nuclear Power Plant Control Room Crews." Thesis, Linköpings universitet, Institutionen för datavetenskap, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-120076.
Повний текст джерелаTurner, John R. "Knowledge Sharing: Examining Employee Perceptions Using Structural Equation Modeling." Thesis, University of North Texas, 2015. https://digital.library.unt.edu/ark:/67531/metadc804846/.
Повний текст джерелаCaiman, Elin. "Psykologisk säkerhet i scrum-team : en fallstudie om kulturella skillnader." Thesis, Luleå tekniska universitet, Institutionen för ekonomi, teknik och samhälle, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-63962.
Повний текст джерелаPurpose – To create a deeper knowledge for how cultural differences influences the work with scrum, with specific focus on psychological safety. Method – A qualitative case study with an inductive approach have been carried out where semi-structured interviews together with observations have been used to collect data. Together with literature a content analysis was then preformed. Result – The study has identified three dimensions that are important to consider when working with scrum. These dimensions are Attitude to the human, Managing the human and Behaviors of the human, and these show how cultural differences creates different basis for psychological safety in scrum teams. Moreover, these insights can lead to improved work with scrum and in turn create more innovative and competitive scrum teams and organizations. Theoretical implications – The study contributes to the literature about psychological safety with empirical theory that shows how cultural differences creates different consequences for psychological safety. More specifically, it shows how these differences in culture are related to one another and affects each other. Another contribution of this study is that the result creates a deeper understanding of how the implementation of scrum and agile transitioning best can be done in a new culture, specifically that is characterized by high power distance, uncertainty avoidance and collectivism. Practical implications – The study shows that the identified differences in culture are related to each other, which means that all needs to be addressed to create a psychological safe scrum team in a new culture. Psychological safety is a prerequisite for self-organized teams, such as scrum teams, and thus the result is of interest for group managers in all companies and organizations working with scrum, both in different cultural contexts and with multinational teams as well as in global virtual teams.
Riccetti, Sauro. "Design of equipment safety & reliability for an aseptic liquid food packaging line through maintenance engineering." Thesis, Brunel University, 2011. http://bura.brunel.ac.uk/handle/2438/5301.
Повний текст джерелаBjörk, Johan, and Kristofer Ellery. "Simulera mera : Ger övning färdighet?" Thesis, Röda Korsets Högskola, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-242.
Повний текст джерелаAim:To describe what nursing students, specializing in intensive care, at a university college think about team based simulation training. Background: Communication and organization in health care are important factors to ensure patient safety. Nurses are called upon to be able to distribute and coordinate work tasks, while at the same time nurses should also be aware of safety promotion in health care to be able to provide safe patient care. There is a need in healthcare for team and communication training where team based simulation appears to be a pedagogic and reliable educational tool. Method: A pilot study where 32 nurses specializing in intensive care, were asked to respond to a survey on what they thought about a previously performed team based full scale simulation training. Results: In general the students confirmed that the exercise had a positive impact on their ability to practice team communication skills and to apply theory in practice. They expressed a wish for more simulation training during their education and in their upcoming professional role. Conclusion: Team based full scale simulation exercises seem to be a pedagogical teaching method to enhance competences and teach students to work together toward a common goal.
Manges, Kirstin. "Transition to home study: the influence of interprofessional team shared mental models on patient post-hospitalization outcomes." Diss., University of Iowa, 2018. https://ir.uiowa.edu/etd/6193.
Повний текст джерелаViklund, Sandra, and Theresa Falck. "Team- och ledarskapsfaktorer som påverkar sjuksköterskors förmåga att arbeta patientsäkert – en litteraturstudie : Team level- and leadership predictors that affect nurses' in their work to achieve patient safety- a literature study." Thesis, Karlstads universitet, Institutionen för hälsovetenskaper, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-42574.
Повний текст джерелаEklund, Therese, and Cecilia Nordmark. "Omvårdnadsteamets arbete intraoperativt beträffande patientsäkerheten : En integrerad systematisk litteraturstudie." Thesis, Karlstads universitet, Institutionen för hälsovetenskaper, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-42693.
Повний текст джерелаIntroduction: Half of all health care-associated injuries occur in conjunction with surgery. The patient care team is a multidisciplinary collaboration where many people from different professions work together in different configurations with patient safety as one of the most important aspects. The operating theatre nurse and the nurse anesthetist are responsible for the patients nursing care before, during and after the surgery. Aim: To describe how the patient care team works intraoperatively regarding the patient safety. Method: An integrated systematic literature study were articles searches where made using the databases Cinahl and PubMed. Eleven articles with quantitative, qualitative and mixed method analysis has been reviewed. Result: The material resulted in three categories: To be prepared, to exchange information with each other and to be familiar with each other’s skills. Conclusion: A large part of the result showed that preparations where the whole patient care team was involved, continuously exchanging information with each other and were familiar with each other’s professional skills enhances the patient safety. The result of this literature study might lead to an increased understanding of the importance of the patient care team for patient safety intraoperatively.
Žigutienė, Rūta. "Kauno regiono greitosios medicinos pagalbos tarnybų darbo vietos saugos kultūros vertinimas." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2014. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2014~D_20140714_134740-45524.
Повний текст джерелаSafety culture is the element of patient safety that purposes to decrease the damage to the patient that may be done during provision of health care service. The purpose of this study was to investigate the safety culture at the workplace of emergency medical service at Kaunas region. Material and methods: Anonymous survey was conducted on March-May in 2012. The staff from eight emergency medical service institutions at Kaunas region took part in the survey (N=325 with response rate of 82.9 %). The Emergency Medical Services Safety Attitudes Questionnaire – EMS–SAQ was used after the permission by the authors was issued. The internal consistency of translated and adapted instrument was sufficiently high (Cronbach α=0,822). Results: The staff of emergency medical service of Kaunas region evaluated six dimensions of safety culture rating team work (76.34 scores), work satisfaction (76.49 scores) and perceptions of management at the highest level (75.98 scores). The lowest ratings were related to stress recognition and present of adverse events, respectively – 49.62 and 37.24 scores. Nurses scored the team work and perceptions of management more positive in comparison to drivers; paramedics have had more positive attitudes towards work satisfaction than physicians. Physicians and paramedics recognised stress more often in comparison to nurses and drivers. The attitudes towards a safety climate, perceptions of management and work satisfaction were more positive in... [to full text]
Albinsson, Elisa, and Gunnhild Nilssen. "Alla redo för time-out och sign-out? : Operationsteamets följsamhet till time-out och sign-out i WHO:s checklista för säker kirurgi." Thesis, Högskolan i Skövde, Institutionen för hälsovetenskaper, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-19443.
Повний текст джерелаBackground: In 2008, the WHO Surgical safety checklist was introduced to reduce mortality, improve patient safety and reduce risk of medical injuries in connection to surgery by means of a communication tool ensuring that checks and interventions are performed. Previous studies show a variation in compliance to the checklist, and that different items not are entirely performed. Aim: To describe the surgical team’s compliance to time-out and sign-out in the WHO Surgical safety checklist. Method: A quantitative cross-sectional study conducted as a non-participatory observational study. Data was collected during 24 observations at two hospitals using a structured observational protocol. Data was analysed using SPSS and reported through descriptive statistics, using pie and bar charts as well as tables and discussion. Result: Time-out was initiated in 95,8 % of the observations and completed in 4,2%. Sign-out was initiated in 100 % of the observations and 29,2 % were completed. No member of the surgical team was responsible for performing the safety checks. In 19 of 22 observations, all three parts of the checklist were signed in Orbit before the sign-out was completed. Conclusion: Both time-out and sign-out are carried out to a great extent, however, compliance with all items of the checklist varies. The study shows a discrepancy between the actual use of the checklist and the administratively reported use of the checklist.
Borglin, Lina, and Martin Eriksson. "Att bevittna patientens utsatthet : En intervjustudie om anestesisjuksköterskans erfarenheter och upplevelser av kommunikation vid akuta omhändertaganden utanför sin ordinarie arbetsmiljö." Thesis, Högskolan i Borås, Akademin för vård, arbetsliv och välfärd, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-407.
Повний текст джерелаJernigan, Mark (J Mark) 1957. "Adding elements of innate human behavior to improve system performance and safety in the design of complex systems with corollaries to improve team performance." Thesis, Massachusetts Institute of Technology, 2002. http://hdl.handle.net/1721.1/91736.
Повний текст джерелаKulp, Caroline, and Sini Kriikkula. "Operationsteamets upplevelser av kommunikationssvårigheter : - En litteraturstudie." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-102021.
Повний текст джерелаBackground: The operating team consists of various professionals who all are an important part of the work. To take advantage of all team members’ unique skills, effective collaboration and communication is required. However, studies have shown that communication difficulties within the team are common, which complicates collaboration and poses a risk to patient safety. Objective: The aim of the study was to investigate the operating team members’ experiences of communication failures in the operating room. Method: Literature study with systematic approach in accordance with Bettany-Saltikov and McSherry (2016). The literature search was conducted in the databases Cinahl and PubMed. Ten qualitative articles were included. Outcome: Communication difficulties were perceived as a result of lack of community within the group, inappropriate behavior, different perspectives and priorities. According to the operating team, the communication difficulties had a negative impact on both patient safety, job satisfaction and efficiency in the operating room. Conclusion: Communication difficulties are a problem in surgical care as it complicates the cooperation in the surgical team. The communication difficulties can result in negative consequences for both the patient and the employees.
Tegnér, Elias, and Elly Westerberg. "Strävan efter den goda kommunikationen i det interprofessionella operationsteamet - en intervjustudie." Thesis, Karlstads universitet, Institutionen för hälsovetenskaper (from 2013), 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-78479.
Повний текст джерелаSöderbäck-Hallman, Magdalena, and Alexander Weman. "Sjuksköterskors beskrivning av omvårdnad för patienter med endokardit." Thesis, Röda Korsets Högskola, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-2545.
Повний текст джерелаBackground endocarditis is a relatively uncommon diagnosis compared to other infectious diseases. Endocarditis affects the heart muscle but is mainly situated in the heart valves. In Sweden today about 500 persons are affected annually, with adequate treatment and care the survival rate is high within 80-90% of all cases. Endocarditis is a complex disease that requires treatment and care from multiple specialists, the time spent in hospital is long compared to other diseases and is often prolonged by complications of the treatment.The Aim of the study was to describe the caring of patients with endocarditis from a nurse’s perspective.The method used was a qualitative analysis using descriptive design, with the use of strategic purposeful sampling with help of inclusion and exclusions criterias. Six Nurses from different backgrounds, genders and workplaces participated in the interview study. The data analysis was conducted using manifest content analysis with some grade of latent analysis included.The Result showed how the informants of the study described caring for patients with endocarditis from a nurses point of view. This is explained by the three major categories: Patients conditions, The Organisations prerequisite and the Nursing staffs experienced and educational level. They all tell about the complexity of caring for patients with endocarditis.The Conclusion of the study showed that Nursing care and the term caring itself are terms that are somewhat hard to grasp because of their wide meaning in the Nursing community. Patients with predeveloped addiction to some sort of drug is a special group of patients to handle, especially when they are infected by endocarditis. Since they have to be cared for in their addiction as well as their infection. How well nurses on infections wards in Sweden care for patients affected by endocarditis depends a lot on what other resources the hospital has and on the experienced level of the nurses working there.
Nikman, Samira. "Multidisciplinärt trakeostomiteam : en litteraturöversikt." Thesis, Sophiahemmet Högskola, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-1862.
Повний текст джерелаHalliday, Cynthia Saldanha. "Toward a Better Understanding of the Roles of Social Exchanges and Psychological Safety on Followers' Change-Oriented Behaviors." FIU Digital Commons, 2019. https://digitalcommons.fiu.edu/etd/3959.
Повний текст джерелаFredriksson, Christina, and Annelie Askling. "Faktorer som påverkar det interprofessionella teamet på operationssal : En litteraturstudie." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-82597.
Повний текст джерелаBackground: Every year, patients in Sweden suffer from healthcare injuries due to inadequate patient safety in healthcare. The operating staff work in a high-risk environment where great demands are placed on the operating team and their communication. An operating theatre nurse, must together with the interprofessional team, fulfill their responsibilities and maintain their expertise, which could otherwise lead to a lack of patient safety. Purpose: The aim of the study was to describe the operating staff's perceptions of factors that are important for a wellfunctioning team. Method: Systematic literature study with qualitative method and content analysis according to Bettany-Saltikov & McSherry`s, (2016) nine-step method. Articles were found using structures search methods in the databases Pubmed and Cinahl. Results: The results of the literature study are based on analyzes of 17 scientific articles. Two main themes emerged with six sub-themes highlighting which factors that were of importance in the operating room. The first main theme is the Organization's responsibility with three sub-themes; Education for effective interprofessional teams, Prerequisites for a safe and secure interprofessional team and Expertise in the interprofessional team. The second main theme is Collaboration with three sub-themes; Interprofessional team, Communication in collaboration, Importance of WHO Surgical Safety Checklist. Conclusion: The interprofessional team includes several professions with a common goal, to provide a safe and secure care to the patient in order to prevent care damage. There are several factors that affect patient safety such as collaboration and communication.
Teske, Christofer, and Sara Andreasson. "Vård i rörelse : En kvalitativ intervjustudie om den mobila vården." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-85513.
Повний текст джерелаIntroduction: Provision of mobile care at the home of patients appears to become necessary as the population becomes increasingly older. But there are challenges in moving acute care from hospitals to the home of patients. Aim: The aim of the study is to describe the experiences of the mobile care. Method: Semi structured interviews are conducted with 12 persons with experience of mobile care in Sweden, such as nurses, doctors, civil servants and politicians. Qualitative latent content analysis was used as an analysis method. Result: The study's result is presented on the basis of a theme "A holistic care given through collaboration in the patient's home environment", with three main categories "borderless cooperation" "resources in the immediate environment" and "holistic view of the patient". The results show that cooperation is of utmost importance to achieve functioning mobile care. Cooperation both on an interorganizational level and on a close teamwork level is required for all of the involved parties in mobile care to take on a joint responsibility for the patient. As mobile care is foremost provided to elderly multimorbid patients, a comprehensive view on patient care is required in which the patient and its relatives experience security. Conclusion: This study suggests that mobile care is seen as a moving care that comes to the seeking person and not the other way around. The resources are distributed where they make the most use, that is, closest to the individual. Mobile care is seen as a complement to the traditional hospital care. This means a different way of working that requires close collaboration between different categories of personnel and organizations, where it does not talk about boundaries but about the patient's needs and situation.
Bisbey, Tiffany. "Toward a Theory of Practical Drift in Teams." Honors in the Major Thesis, University of Central Florida, 2014. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/1574.
Повний текст джерелаB.S.
Bachelors
Psychology
Sciences
Athanassiou, Georgios [Verfasser]. "Mariners’ Adaptive Performance under Stress : Individual Visual Performance and Team Safety Performance as Indicators of Adaptive Responses to Task-Integral Cognitive and Affective Workload during a Complex Ship Management Task / Georgios Athanassiou." Kassel : Kassel University Press, 2016. http://d-nb.info/1119923905/34.
Повний текст джерелаSilva, Amarilis Pagel Floriano da. "SEGURANÇA DO PACIENTE NA ATENÇÃO PRIMÁRIA EM SAÚDE: SABERES E PRÁTICAS DO PROFISSIONAL ENFERMEIRO." Universidade Franciscana, 2018. http://www.tede.universidadefranciscana.edu.br:8080/handle/UFN-BDTD/611.
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Introduction: patient safety represents an important concern in the quality of health care and has an analogy with the prevention of errors in care. Adverse events take place wherever health care is provided and, in many circumstances, could be prevented through preventive measures. Objective: to identify the actions of the professional practice of nurses that indicate patient safety in primary health care, with a view of qualifying health care. Specific Objectives: to identify, in the literature the area, the scientific publications related to patient safety actions related to the nurses' performance in primary health care and to understand the conceptions of nurses working in the Family Health Strategy on safety knowledge and practices of the patient in primary health care. Methodology: This dissertation was developed in two stages, one consisting of a integrative review of literature in which scientific articles were found with the objective of the review. The second stage consisted of a descriptive-exploratory study with a qualitative approach, developed in Family Health Strategies located in the western region of Santa Maria - RS. The data were analyzed according to the thematic content analysis of Minayo. This research is approved by the Research Ethics Committee of the Franciscan University, and is registered under opinion nº 1.876.855. Results: The publications found in the review totaled 10 scientific articles presented in a synthesis table, in order to characterize the publications according to author / year, objectives, type of study, approach, results and conclusions. In field research, the analysis process resulted in the organization of three thematic categories: Patient safety meanings for the nurses of the Family Health Strategy; Barriers to safe care in the context of Primary Health Care and Strategies for safe care in the work of nurses of the Family Health Strategy. Discussion: the findings of the integrative literature review did not allow a more in-depth analysis of the topic, since the studies about nurses' work in primary care related to the subject are scarce and incipient, indicating the existence of spaces for new research to be carried out. Many articles, because they are international, have brought a primary health care organization that is very similar to the Family Health Strategy model and traditional Basic Health Units, which are characteristic models of Primary Care in Brazil. In the field research, it was noticed that the conception of the majority of the nurses regarding the safety of the patient are related to the safe care that avoids damages. Some participants highlighted the concern about infection prevention as one of the criteria for avoiding risk and harm. Some difficulties were also signaled both in the speeches and in the professional performance, through the observations. Although many difficulties have been mentioned and observed in nurses' work, it is important to highlight that they have been developing some strategies to promote safe care, even in adverse working conditions. Final Considerations: the integrative review made it possible to identify and ponder existing studies on nurses' performance in primary care pertinent to patient safety. The data allowed to address nurses' understanding of the patient's knowledge and safety practices in primary health care, as well as the main barriers and strategies for the development of safe care. It is necessary to explore in depth questions related to patient safety in the work of nurses, since this topic presents a strategic role in the planning and implementation of health team actions and in the direct supervision of the work of Community Health Agents. attributions are heavily included actions of health promotion and care management, which impacts on a role of articulation and leadership towards the team.
Introdução: a segurança do paciente representa uma importante preocupação na qualidade do cuidado de saúde e tem analogia com a prevenção de erros no atendimento e ao cuidado. Eventos adversos acontecem em qualquer lugar onde se proporcionam cuidados de saúde e, em muitas circunstâncias, poderiam ser evitados por meio de medidas preventivas. Objetivo: identificar as ações da prática profissional do enfermeiro que indiquem a segurança do paciente na atenção primária em saúde, com vistas à qualificação do cuidado em saúde. Objetivos Específicos: identificar, na literatura da área, as publicações científicas referentes às ações de segurança do paciente relacionadas à atuação do enfermeiro na atenção primária em saúde e compreender as concepções de enfermeiros atuantes na Estratégia de Saúde da Família acerca dos saberes e práticas de segurança do paciente na atenção primária em saúde. Metodologia: esta dissertação foi desenvolvida em duas etapas, uma constituída de uma revisão integrativa de literatura na qual foram encontrados artigos científicos que atenderam ao objetivo da revisão. A segunda etapa constou de um estudo descritivo-exploratório com abordagem qualitativa, desenvolvido em Estratégias de Saúde da Família localizadas na região oeste de Santa Maria – RS. Os dados foram analisados segundo análise de conteúdo temática de Minayo. A pesquisa possui aprovação do Comitê de Ética em Pesquisa da Universidade Franciscana, estando registrada sob o parecer nº1.876.855. Resultados: As publicações encontradas na revisão totalizaram 10 artigos científicos apresentados em um quadro síntese, a fim de caracterizar as publicações segundo autor/ano, objetivos, tipo de estudo, abordagem, resultados e conclusões. Na pesquisa de campo, o processo de análise resultou na organização de três categorias temáticas: Significados de segurança do paciente para as enfermeiras da Estratégia de Saúde da Família; Barreiras para o cuidado seguro no contexto da Atenção Primária em Saúde e Estratégias para o cuidado seguro na atuação das enfermeiras da Estratégia de Saúde da Família. Discussão: os achados da revisão integrativa de literatura não permitiram uma análise mais aprofundada sobre o tema, pois os estudos acerca do trabalho do enfermeiro na atenção primária relacionados à temática são escassos e incipientes, o que indica a existência de espaços para que novas pesquisas sejam realizadas. Muitos artigos, por serem internacionais, trouxeram uma organização de atenção primária em saúde que pouco se assemelha com o modelo de Estratégia de Saúde da Família e Unidades Básicas de Saúde tradicionais, que são modelos característicos da Atenção Primária do Brasil. Na pesquisa de campo, percebeu-se que a concepção da maioria das enfermeiras quanto à segurança do paciente está relacionada com o cuidado seguro que evita danos. Algumas participantes elencaram a preocupação com a prevenção de infecções como um dos critérios para se evitar o risco e o dano. Algumas dificuldades também foram sinalizadas tanto nas falas como na atuação profissional, por meio das observações. Embora muitas dificuldades tenham sido referidas e observadas na atuação das enfermeiras, destaca-se que estas vêm desenvolvendo algumas estratégias para potencializar um cuidado seguro, mesmo que em condições de trabalho adversas. Considerações Finais: a revisão integrativa possibilitou identificar e ponderar sobre os estudos já existentes sobre a atuação do enfermeiro na atenção primária pertinentes à segurança do paciente. Os dados permitiram abordar a compreensão das enfermeiras sobre os saberes e práticas de segurança do paciente na atenção primária em saúde, assim como as principais barreiras e estratégias para o desenvolvimento do cuidado seguro. É necessário explorar em profundidade questões pertinentes à segurança do paciente no trabalho do enfermeiro, uma vez que este tema apresenta papel estratégico no planejamento e implementação das ações de equipe de saúde e na supervisão direta do trabalho dos Agentes Comunitários de Saúde. Ainda, dentre suas atribuições estão fortemente incluídas as ações de promoção da saúde e de gestão do cuidado, o que repercute em um papel de articulação e liderança perante a equipe.
Gunnarsson, Liselotte, and Victoria Arvidsson. "Sjuksköterskors upplevelser av kommunikation i traumateam- En kvalitativ intervjustudie." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-62528.
Повний текст джерелаBackground: Trauma care involves the care of seriously somatic injured patients. To care for these patients a multi-disciplinary team is gathered, which requires teamwork and good communication skills for a safe and structured care of the patient. Communication and the transmit of information comprise a risk in healthcare and the relationship between bad communication and lacking treatment results is widely documented. Trauma care is a stressful situation that put demands on the nurse at the emergency department, and means challenges to achieve an effective collaborative communication. Aim: The aim was to illustrate nurses´ experiences of communication in the trauma team. Method: The study was conducted with a qualitative approach, where semi-structured interviews were performed with 11 nurses working in two emergency departments. All the data was analyzed by the help of qualitative content analysis method. Result: Study results generated in a theme Team communication -and its complexity. The result is presented in three main categories: The challenges of collaborative communication, Structure- to relate to certain rules and The Communication affects the patient. The complexity of communication within the team depends on personal characteristics and how teamwork otherwise functions. The value of leadership is essential as well as a structured approach and how to relate to policies and routines. The communication quality affects the care process for the patient and can be improved by trauma training. Conclusion: The study identifies the complexity of communication within the trauma team. Leadership and team interaction plays a crucial role for the outcome of the patient. It is of importance to communicate direct and clear. Lack of communication leads to impaired teamwork and adverse consequences for the patient safety. By trauma training, communication can be promoted and the nurses develop professional skills.
Dias, Alexsandro de Oliveira. "Atendimentos realizados por times de respostas rápidas em hospitais." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/22/22132/tde-28032018-183143/.
Повний текст джерелаPatient safety has become indispensable for the health system. Therefore, initiatives have been implemented over the years to reduce adverse events. The performance of the Rapid Response Team (RRT) has been consolidated as a strategy to provide care to patients who get in critical conditions at the general hospital admission unit. The service is constituted by a multiprofessional team with an approach in the intensive treatment of patients with signs of acute clinical deterioration in the inpatient unit, through codes established for its activation, in order to reduce the probability of worsening of the clinical condition or imminent death risk of the patient during the hospitalization period. The study aims to characterize the critical requirements in emergency care provided by the RRT at a public hospital in the state of Paraná and a philanthropic hospital in the state of São Paulo, Brazil. This is a descriptive, exploratory study with a qualitative approach, adopting the Critical Incident Technique to guide the methodological procedures, performed with 62 health professionals, being 19 physicians, 20 physiotherapists and 23 nurses. The results were grouped into 89 critical incidents extracted from the interviews. Data analysis consisted of the identification and grouping of 220 behaviors and 130 consequences. Based on the situations, behaviors and consequences identified, there is a need to improve the afferent pathway of RRT (recognition of clinical deterioration and activation of the RRT in the unit), the qualification of the professionals of the inpatient units to perform the necessary initial technical skills in the emergency response until the arrival of the RRT, the failure in the interaction among the different professionals during blue-code care with negative effects for the systematization of emergency care to revert the patients\' CPA and the negative feelings and emotions generated in the professionals as impediments to code-blue emergency care. Regarding the positive highlights from the situations, behaviors and consequences identified, the arrival time of the RRT in the unit to perform the emergency care, the systematization of the cardiopulmonary resuscitation service performed by the multiprofessional team, the restoration of the patient\'s vital functions after the care and transfer of the patient after the end of the care from the inpatient unit to an intensive care environment. As the main suggestions to the RRT, the interviewees pointed out the importance of emergency care training for the professionals of the inpatient units, the need to keep the professionals working exclusively in the RRT, the appropriate number of professionals in the room during emergency care and the importance of registering the patient\'s decision not to reanimate in the patient file in view of palliative care. The significant frequency of positive over negative results was highlighted, which permeated the situations, behaviors and consequences deriving from the interviews. It is inferred that, even though these professionals encountered difficulties during the visits to patients who became critical in the wards, the positive reports predominated in the various categories that legitimized the importance of implementing this service, as a contribution to the quality and safety of hospitalized patients
Rydgren, Madeleine, and Emma Svensson. "Operationsteamets omvårdnadsåtgärder för att förebygga hypotermi : En observationsstudie med kvantitativ ansats." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-85432.
Повний текст джерелаIntroduction: The definition of hypothermia is when the patients core temperature is below 36 degrees. All the patients have an increased risk of becoming hypothermic during surgical procedures if no preventive measures are taken. Hypothermia is preventable with either heat inducing measures or by maintaining the patient’s normal temperature. Hypothermia can lead to complications for the patients such as impaired wound healing, Increased risk of postoperative wound infection, increased risk of bedsores, heart conditions and increased tendency to bleed. Although studies have shown knowledge of this topic hypothermia is a common occurrence in surgical procedures. Aim: The aim of this study was to investigate in which extension nursing measures were used by the operations team to prevent hypothermia intraoperatively. Method: The study was a quantitative structured observational study. Data was collected during 43 operations at two hospitals in southern Sweden. The observations followed a protocol that was created along AORN (Association of perioperative registered nurses) and NICE: s (National institute for health and care excellence) recommendations and contained 12 nursing measures to prevent hypothermia. Result: All the patients received warm blankets and warm intravenous fluids. All the operating staff used the WHO: s checklist and the majority avoided unnecessary patient exposure. The nursing measures that were used less frequently were warm air blankets, feet-and leg warmers and temperature measurement on the patient. Aluminum blankets, heating mattress, heat caps and warm skin antisepsis were never used. On the patients of whom a temperature was taken, the nursing measures had a good effect since the majority of the patients were no longer hypothermic at the end of the intraoperative phase. Conclusion: The operation team always used care measures to prevent hypothermia, some to a greater extent than others. Some patients were still hypothermic at the end of the intraoperative phase, which may indicate that an improvement could occur in the nursing measures that weren’t used as frequently.
Veiga, Viviane Cordeiro 1976. "Atuação do time de resposta rápida nos indicadores de melhoria da qualidade assistencial." [s.n.], 2013. http://repositorio.unicamp.br/jspui/handle/REPOSIP/311906.
Повний текст джерелаTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Introdução: A segurança do paciente tornou-se prioridade estratégica para o sistema de saúde. Ações têm sido implantadas nas Instituições, na tentativa de reduzir a mortalidade hospitalar e os eventos não previsíveis. Objetivo: O objetivo deste trabalho é avaliar a atuação do time de resposta rápida nos indicadores de melhoria da qualidade assistencial, comparando dois períodos de seguimento. Casuística e Método: No período de maio de 2010 a dezembro de 2012, foram avaliados os atendimentos realizados pelo time de resposta rápida, em pacientes com idade maior ou igual a 18 anos. O estudo foi dividido em dois períodos, denominado "antes" e "depois", sendo que o primeiro compreendeu o intervalo de maio de 2010 a julho de 2011 e o segundo, entre agosto de 2011 e dezembro de 2012. O acionamento do grupo era feito por qualquer profissional da equipe assistencial, baseado em critérios preestabelecidos e amplamente divulgados na Instituição. Após 15 meses de seguimento, optou-se pela alteração nos critérios de acionamento (período "depois"), visando à detecção precoce da deterioração clínica e baseados no perfil epidemiológico da Instituição. No período, foram atendidos 8009 pacientes, sendo 1830 no "antes" e 6179 no "depois", com idade média de 66,37±16,88 e 65,99±20,08 anos, respectivamente. O gênero masculino foi predominante em ambos os períodos, representando 52,5% dos atendimentos no primeiro e 53% no segundo. No período "antes", as alterações respiratórias representaram o maior número de chamados, enquanto que, no período "depois", a busca ativa de sepse foi o critério mais acionado, seguido pelas alterações respiratórias. Foi denominado código azul, os atendimentos de parada cardiorrespiratória e código amarelo, os atendimentos decorrentes de deterioração clínica. Os indicadores de qualidade assistencial mensurados foram: reinternação precoce em terapia intensiva (UTI), transferências para UTI, chamados de código amarelo, número de paradas cardiorrespiratórias fora da UTI e mortalidade hospitalar. Resultados: No período analisado, não houve diferença estatisticamente significante de perfil dos pacientes nos dois períodos, quanto ao gênero e idade (p=0,631 e p=0,550, respectivamente). Ao longo dos meses avaliados, houve um aumento significativo no número total de atendimentos, com 98,1% de chamados de código amarelo no segundo período. A proporção encontrada de códigos azuis foi de 7,59% no período "antes" e 1,91% no período "depois". O número de pacientes atendidos que necessitaram transferência para a UTI representava 33,3% dos atendimentos no período "antes", com redução para 20,8% no "depois" (p<0,001). Houve redução no número de reinternações em UTI na comparação entre os dois períodos (p <0,001). Não houve diferença estatisticamente significante no número de paradas cardiorrespiratórias fora da UTI e na mortalidade entre os períodos, no entanto, com tendência de redução no decorrer do tempo. Conclusão: A implantação do time de resposta rápida resulta em melhoria da qualidade assistencial, com redução no número de transferências e reinternação precoce em UTI. O número de paradas cardiorrespiratórias e a mortalidade apresentaram tendência de redução ao longo do tempo estudado
Abstract: Introduction: Patient safety has become a strategic priority for the health system. Actions have been implemented in health institutions in an attempt to reduce mortality and adverse events. Objective: The objective of this study is to evaluate the performance of the rapid response team on indicators of improving quality of care, comparing two periods of follow-up. Methods: Between May 2010 and December 2012, we assessed the care provided by a rapid response team in patients aged greater than or equal to 18 years. The study was divided into two periods, "before" and "after", the first of which included the period May 2010 to July 2011 and the second between August 2011 and December 2012. The group was called by any professional health care team, based on predetermined criteria. After 15 months of follow-up, we decided to drive change in criteria (period "after"), aimed at early detection before clinical deterioration and based on the epidemiological profile of the institution. During the period, 8009 patients were treated, and 1830 in the period "before" and in 6179 "after", with a mean age of 66.37 ± 16.88 and 65.99 ± 20.08 years, respectively. The male gender predominated in both periods, representing 52.5% of visits in the 1st period and 53% in the second. In the period "before", the respiratory changes accounted for the largest number of calls, while in the period "after" sepsis was the most called, followed by respiratory disorders. Blue code was called the attendance of cardiac arrest and yellow code, the clinic visits resulting from deterioration. The quality of care indicators measured were: unplanned admission to intensive care unit (ICU), ICU transfers, time-driven service, called code yellow and number of cardiac arrests outside the ICU. Results: During the period analyzed, there was no statistically significant difference in the profile of patients in both periods, according to gender and age (p = 0.631 and p = 0.550, respectively). Over the months studied, there was an increase of approximately 300% in the total number of visits, with 98.1% of calls to code yellow in the second period. The proportion of code blue was 7.59% in the period "before" and 1.91% in the period "after." The number of patients seen who required transfer to the ICU represented 33.3% of attendances in period "before", with a reduction to 20.8% in the "after" (p <0.001). There was a reduction in the number of unplanned ICU admissions when comparing the two periods (p <0.001). There was no statistically significant difference in the number of cardiac arrests outside the ICU and mortality between the periods. Conclusion: The implementation of the rapid response team results in improving quality of care, reducing the number of transfers and early readmission to the ICU. The number of cardiopulmonary arrests and mortality tended to decrease over time studied
Doutorado
Fisiopatologia Cirúrgica
Doutora em Ciências
Casse, Christelle. "Concevoir un dispositif de retour d'expérience intégrant l'activité réflexive collective : un enjeu de sécurité dans les tunnels routiers." Thesis, Université Grenoble Alpes (ComUE), 2015. http://www.theses.fr/2015GREAH024/document.
Повний текст джерелаOperating experience feedback, mainly through accident analysis is a method of choice for safety management in high risk organizations. The present research takes place in the field of road tunnel safety, proposing an integrated approach of experience feedback from the daily management of safety by tunnel monitoring staff through collective spaces for discussion and experience building.Our hypothesis is that safety in such dynamic environments as road tunnels depends on the capacity of operating teams to face the unexpected events, disturbances and accidents. This capacity is built through discussions between operating staff and with the management about the difficulties encountered during work. The return on operating experience should allow the debate on work activity in order to reach a better safety management, foster individual development and a better organization. However, there are organizational conditions for the debate to be possible and sustainable.A research and intervention protocol was set up with a road tunnel operator to test and improve a scheme for the return on operating experience based on individual and collective activity. Analyses were conducted to help operational staff link the way events are treated in day to day security management with the processing in the operational experience feedback scheme. An analysis of the current scheme showed that it is focussed on major traffic events, comprising of a set of procedures and formal rules, while the operational events, felt as critical by operators do not have a framework for discussion. Further, work activity analysis shows that operational staff develops informal spaces of collective exchanges to organize work, anticipate hazards and analyse events.Organizational simulations including operating staff, managers and the research partners were set up to transform the feedback scheme. The simulation led to an enlarged framework for feedback, defining the events to be analysed and participants to be included. The new scheme roots in the existing professional processes, develops inter-professional as well as inter-organization discussion spaces. The new scheme facilitates the sharing of experience among operating staff and structures the informal organizational practices we observed.Inter-professional discussion spaces, conducted by the team managers, were set up based on the analysis of simulated events. These structured discussion spaces proved to be effective in the confrontation of work practices, events and roles representations as well as conducive for knowledge transmission. The discussion space allows setting transverse operational rules and highlights the need for formal rules to be set by the management. The inter-professional discussion spaces are operant in improving the formal organisation as well as developing the activity of operational staff. This methodology favoured the building of experience from event analysis.This research-intervention was an opportunity to review the official classification of road tunnel events. The conditions for an integrated operating experience feedback scheme are set and discussed, as well as the implementation of simulation-based discussion spaces.From our results, we re-consider the design of interventions in organizational design, as well as the role of the intervening ergonomist
Hendricks, Rahzia. "The use of in vitro assays to screen for endocrine modulation." Thesis, University of the Western Cape, 2008. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_5859_1259070342.
Повний текст джерела 
Aspalathus linearis (A. linearis), commonly known as Rooibos tea or Red bush tea and amellia sinensis (C. sinensis) or Black tea are beverages that are consumed throughout theworld. These teas possess antioxidant, immunomodulating and anti-cancer actions. The aim of this study was to use in vitro assays to screen Rooibos and Black tea for endocrine modulation. The immune modulating effects of Rooibos and Black tea were investigated using an in vitro whole blood culture (WBC) assay. Unstimulated WBCs treated with Rooibos tea secreted higher levels of IL-6, IL-10 and IFN&gamma
than cultures treated with DMSO control. Rooibos treatment of stimulated WBCs resulted in higher IL-6, lower IL-10 and no effect on IFN&gamma
secretion compared to DMSO treated stimulated WBC. Black tea treatment of stimulated WBC resulted in decreased IL-6, IL-10 and IFN&gamma
secretion compared to the DMSO treated stimulated WBC. Extracts of Rooibos and Black tea were assessed for phytoestrogens using quantitative estrogen ELISAs. Both teas contain phytoestrogens. The quantitative ELISAs showed that Rooibos tea contained significantly lower estrone (E1), estradiol (E2) and estriol (E3) levels than Black tea. The effects of Rooibos and Black tea on proliferation of the estrogen dependant MCF-7 cell line was determined to further characterise the phytoestrogenic properties of the teas. Both Rooibos and Black tea extracts caused a significant inhibition of MCF-7 proliferation. This study shows that Rooibos tea and Black tea are beverages that can either stimulate or suppress the immune system. Also, both teas contain significant levels of phytoestrogens as determined by quantitative ELISAs. The current study confirms previous reports showing inhibition of growth in breast cancer cell lines by phytoestrogens. The findings extend related observations on the anti-carcinogenic potential of the two teas.
Moreira, Isadora Alves. "Notificação de eventos adversos: o saber e o fazer de enfermeiros." Universidade Federal de Goiás, 2018. http://repositorio.bc.ufg.br/tede/handle/tede/8759.
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Introduction: Patient safety has been a topic of discussion in health institutions and the reporting of adverse events is one of the main indicators used to assess the quality of care provided. The nurse, supervisor of the nursing team, has a prominent role in risk management and through the systematic notification of these events should implement preventive strategies for improvements in the quality of care and patient safety. Objective: To analyze nurses' knowledge and performance through the process of reporting adverse events in hospitalized patients. Method: A descriptive, mixed-type cross-sectional study developed at a teaching hospital in the Center-West region of Brazil, with the participation of 60 nurses from the various Clinical Units. Quantitative data were obtained through VIGIHOSP reports, online hospital notification systems, for 2016 and 2017 and analyzed statistically by absolute and relative frequencies. Qualitative data were obtained through interviews with nurses through a structured instrument, in March 2018. The contents of the ATLAS.ti 8.0 software were analyzed and three contents were analyzed: The Nurse's Knowledge; The Making of the Nurse; Intervening factors for the reporting of adverse events. Results and Discussion: In VIGIHOSP, 2495 incidents were reported, the main ones related to surgeries (60.6%) and medications (23.3%). As for surgeries, 98.6% were cancellation of the surgical procedure, being 23.1% due to patient non-attendance, 18.4% due to lack of organizational structure and 15% due to lack of patient's clinical conditions. Of the drug-related incidents, 61.8% were prescription errors and 27.6% dispensing errors. As for the profile of the participants, 46.6% work at night or mixed shift, have more than one employment relationship, working for more than 40 hours a week. It was evidenced underreporting of incidents, since most nurses do not notify the events in the system. Although they reveal knowledge of the institution's event notification system, they do not know its flow, especially regarding the return to the notifier. Factors related to underreporting of incidents were lack of time, lack of professionals / human resources, unavailability of computers for notification and low qualification of some professionals to use the online program. Conclusions: The need for greater investment in nurses' training on the dynamics and flow of the hospital's notification system is evident through continuing education programsinvolving the communication of events as an educational strategy to achieve improvements in the quality of practice care and patient safety.
Introdução: A segurança do paciente tem sido tema de discussão nas instituições de saúde e a notificação dos eventos adversos um dos principais indicadores utilizados para avaliar a qualidade da assistência prestada. O enfermeiro, supervisor da equipe de enfermagem, tem papel de destaque na gestão de riscos e por meio da notificação sistemática desses eventosdeve implementar estratégias preventivas para melhorias da qualidade da assistência e segurança do paciente. Objetivo: Analisar o conhecimento e a atuação dos enfermeiros mediante o processo de notificação de eventos adversos de pacientes hospitalizados. Método: Estudo do tipo descritivo, de natureza mista e corte transversal, desenvolvido em um hospital de ensino da região Centro-Oeste do Brasil, com a participação de 60 enfermeiros das diversas Unidades Clínicas. Os dados quantitativos foram obtidos por meio de os relatórios do VIGIHOSP, sistemas online de notificação do hospital, anos 2016 e 2017 e analisados estatisticamente por meio de frequências absolutas e relativas. Os dados qualitativos foram obtidos por meio de entrevistas com os enfermeiros mediante um instrumento estruturado, no mês de março de 2018. Foram inseridos no software ATLAS.ti 8.0 e realizada análise de conteúdo sendo evidenciadas três categorias: O Saber do Enfermeiro; O Fazer do Enfermeiro; Fatores intervenientes para a notificação de eventos adversos. Resultados e Discussão: Foram notificados no VIGIHOSP, 2495 incidentes, os principais relacionados a cirurgias (60,6%) e medicações (23,3%). Quanto às cirurgias, 98,6% foi cancelamento do procedimento cirúrgicos sendo 23,1% por não comparecimento do paciente, 18,4% por falta de estrutura organizacional e 15% por falta de condições clínicas do paciente. Dos incidentes relacionados a medicamentos, 61,8% foram erros de prescrição e 27,6% erros de dispensação. Quanto ao perfil dos participantes, 46,6% trabalham no noturno ou turno misto, possuem mais de um vínculo empregatício, atuando por mais de 40 horas semanais. Foi evidenciada subnotificação de incidentes, visto que a maioria dos enfermeiros não notificam os eventos no sistema. Apesar de revelarem conhecimento do sistema de notificação de eventos da instituição, desconhecem o seu fluxo, especialmente em relação ao retorno ao notificador. Como fatores relacionados a subnotificação de incidentes foram ressaltados a falta de tempo, falta de profissionais/recursos humanos, indisponibilidade de computadores para notificação e baixa qualificação de alguns profissionais para utilizar o programa online. Conclusões: Torna-se evidente a necessidade de maior investimento na capacitação dos enfermeiros acerca da dinâmica e fluxo do sistema de notificação do hospital por meio de programas de educação continuada envolvendo a comunicação dos eventos como estratégia educativa para o alcance de melhorias na qualidade da prática assistencial e segurança do paciente.
Braga, Quéren de Pádua. "Incidentes em unidades de atenção primária em saúde: percepção da equipe de enfermagem." Universidade Federal de Goiás, 2018. http://repositorio.bc.ufg.br/tede/handle/tede/9145.
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Introduction: Primary Health Care is the gateway and the first point of contact between the patient and the health system. Investigations focused on patient safety at this level of care are scarce but essential for diagnosing care processes for that preventive measures are taken to improve the quality of care and minimize possible incidents. There is a need for more nursing commitment to involve patients and professionals in the prevention of incidents in this context. Objective: To analyze the perception of professionals of the nursing team regarding the occurrence of incidents in patients attending primary healthcare units. Methodology: A cross-sectional descriptive study with a mixed approach, developed in 24 Basic Health Units of a municipality in the Central South Region of Goiás, with a population of 97 professionals from the nursing team. The data were collected in March 2018 through an interview with the PCISME (Primary Care International Study of Medical Errors) questionnaire to register incidents in APS, adapted and validated for the Brazilian reality. Descriptive analysis of quantitative data and content analysis of qualitative data were performed with the help of ATLAS.ti 7.5.4. Results / Discussion: We identified 88 incidents, divided into care: the most frequent were the vaccination, with 26 reports, followed by medication and fall; and administrative: being 11 related to administrative service and seven organizational structure and material resources. Among the incidents, 52 were considered adverse events, as they caused damage to the patient, two of which were permanent damage and two deaths. The professional category involved in the highest number of incidents were the nursing technicians in 45 reports, followed by doctors, administrative staff and nurses. The results presented the need to deepen this theme in other primary care services in order to improve the quality of care provided by qualified professionals and improve the quality of the organization of services and consequently the safety of patient care. Conclusions: The perception of nursing team's evidenced the need to sensitize managers and health professionals in order to expand strategies of permanent education, the use of instruments of notification of the incidents, since these actions contribute in the diagnosis of the health situation and professionals to promote improvements through safe and quality care. It should be emphasized that encouraging the production of research related to the subject in PHC is a way forward.
Introdução: A Atenção Primária a Saúde é a porta de entrada e o primeiro ponto de encontro entre o paciente e o sistema de saúde. Investigações com foco em Segurança do Paciente neste nível de atenção são escassos, mas imprescíndiveis por levantar diagnósticos dos processos assistenciais para que medidas preventivas sejam adotadas a fim de melhorar a qualidade do atendimento e minimizar possíveis incidentes. Há necessidade de maior compromisso da enfermagem no sentido de envolver os pacientes e profissionais para a prevenção de incidentes neste contexto. Objetivo: Analisar a percepção dos profissionais da equipe de enfermagem quanto à ocorrência de incidentes em pacientes atendidos em unidades de serviços da atenção primária à saúde. Metodologia: Estudo descritivo transversal com abordagem mista, desenvolvido em 24 Unidades Básicas de Saúde de um município da Região Centro Sul de Goiás, com população de 97 profissionais da equipe de enfermagem. Os dados foram coletados em março de 2018 por meio de entrevista auxiliada pelo questionário PCISME (Primary Care International Study of Medical Errors) pioneiro no sentido de registrar incidentes na APS, adaptado e validado para a realidade brasileira. Foi realizada análise descritiva dos dados quantitativos e análise de conteúdo dos dados qualitativos com o auxílio do ATLAS.ti 7.5.4. Resultados/Discussão: Foram identificados 88 incidentes, divididos em assistenciais: sendo os de vacinação os mais frequentes, com 26 relatos, seguido de medicação e queda; e administrativos: sendo 11 relacionados ao atendimento administrativo e sete a estrutura organizacional e recursos materiais. Dentre os incidentes, 52 foram considerados eventos adversos, pois causaram dano ao paciente, sendo dois de dano permanente e dois óbitos. A categoria profissional envolvida no maior número de incidentes foram os técnicos de enfermagem em 45 relatos, seguido pelos médicos, administrativos e enfermeiros. Os resultados mostraram a necessidade de aprofundamento dessa temática nos demais serviços de atenção primária com intuito de melhorar a qualidade da assistência prestada por profissionais capacitados e melhorar a qualidade da organização dos serviços e consequentemente a segurança no atendimento aos pacientes. Conclusões: A percepção da equipe de enfermagem evidenciou a necessidade de sensibilizar os gestores e profissionais de saúde no sentido de ampliar as estratégias de educação permanente, o uso de instrumentos de notificação dos incidentes, já que estas ações contribuem no diagnóstico da situação de saúde e qualificação dos profissionais para promoção de melhorias mediante um cuidado seguro e com qualidade. Ressalta-se que o incentivo à produção de pesquisas relacionadas ao tema na APS é um caminho a seguir.
Batalha, Edenise Maria Santos da Silva. "A cultura de segurança do paciente na percepção de profissionais de enfermagem de um hospital de ensino." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/7/7140/tde-03012013-105906/.
Повний текст джерелаThis is a descriptive-exploratory quantitative study, which aimed to evaluate the perception of nursing professionals from a teaching hospital about the dimensions of patient safety culture and identify the intervening factors that influence patient safety. The study was developed in a teaching hospital from São Paulo city, and the population comprised 305 nursing professionals. This study was approved in the Ethic committees from the EEUSP and the studied teaching hospital. Data from this study were obtained from February to June in 2012, by using the questionnaire Hospital Survey on Patient Safety Culture from the Agency for Health Research and Quality. The questionnaire comprises ten dimensions of patient safety, two outcome variables, the degree of patient safety and the number of communicated adverse events (AE). Data were analyzed by using analytic and descriptive statistics. The instrument of data collection was reliable, as evidenced by the total Cronbachs Alpha of 0.90. The characterization of the sampling consisted of 18.9% of nurses, 26.6% of technicians, and 54.5% of auxiliaries, which are in the age group among 26 and 40 years. In dimension Teamwork within units 72.5% of professionals agree that when there is overwork they collaborated between them. Concerning dimension Supervisor/Manager Expectations and Actions Promoting Patient Safety 78.3% alleged that the supervisor is open to communication about problems of patient safety. Regarding dimension Management Support for Patient Safety 53.6% realize that the hospital administration do not provide a work climate that favors the patient safety. Concerning Feedback and Communication About Error 12.3% never discuss ways to prevent errors and 19.3% said they always discuss. According to dimension Nonpunitive Response to Errors 78.2% consider that their errors can be used against them. Concerning dimension Overall Perceptions of Patient Safety 60.2% reveal not be by accident that more serious mistakes do not happen in unity, and 52.9% agree to have security problems in the unit. Regarding dimension Frequency of Events Reported \": the error category did not affect its notification, and 73.5% answered not notify any AE in the past 12 months. Concerning to the Patient Safety Grade, ranks as the most acceptable. We conclude, on the topic of patient safety, which the advances on current scenario of health organizations are challenging, however it is imperative the effective mobilization of professionals in order to consolidate a culture of safety fruitful and constructive.
Costa, Daniele Bernardi da. "Cultura de segurança do paciente em serviços de enfermagem hospitalar." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/22/22132/tde-06022015-192856/.
Повний текст джерелаThis is a quantitative, descriptive research, which the goal is to investigate patient safety culture from the perspective of professional from the hospital nursing team. The study was conducted in two hospitals, and approved by the Research Ethics Committee of the EERP and of both hospital institutions. The sample consisted of 46 nurses, 124 nursing assistants and 112 nursing technicians. Data collection occurred during the months of June and July 2013, through the questionnaire Hospital Survey on Patient Safety Culture, of the Agency for Health Research and Quality. Data analysis occurred using descriptive statistics. Regarding the characterization of participants, 84.7% were female and 15.3% male, with a mean of 37.7 years of age, there is a predominance of nursing technicians with 41.2%, nursing assistants with 34.6 % and 24.3% of nurses. Based on the assessment of the dimensions is stressed that, in the dimension teamwork across hospital units, 69.4% of professionals agree that when a lot of work needs to be done quickly, they work together as a team to get the work done; about the dimension supervisor/ manager expectations and actions promoting safety, 70.2% agree that their supervisor/ manager overlooks patient safety problems that happen over and over.Related to organizational learning and continuous improvement, 56.5% agree that there is evaluation of the effectiveness of the changes after its implementation.Onhospital management support for patient safety, 52.8% of the professionals refer that the actions of hospital management show that patient safety is a top priority.On the overall perception of patient safety, 57.2% disagree that patient safety is never compromised due to higher amount of work to be completed.In what refers to feedback and communication about error, 57.7% refer that always and usually receive such information. Relative to communication openness, 42.9% said they never or rarely feel free to question the decisions / actions of their superiors.Onfrequency of event reporting, 64.7% said often and always notify mistakes that could, but do not harm the patient.Aboutteamwork across hospital units is noted similarity between the percentages of agreement and disagreement, as on the item there is a good cooperation among hospital units that need to work together, that indicates 41.4% and 40.5% respectively.Related to adequacy of professionals, 77.8% disagree on the existence of sufficient amount of employees to do the job, 52.4% agree that shift changes are problematic for patients. On nonpunitive response to errors, 71.7% indicate that when an event is reported it seems that the focus is on the person.On the patient safety grade of the institution, 41.6% classified as very good. About notifications made in the last 12 months, 77.80% did not report any events.It is conclude that the involvement of nursing professionals is essential to building a positive safety culture focused on improvements to patient safety
Webster, Alva. "Promoting Long-Term Iontophoresis through Safety Electronics." University of Cincinnati / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1523628670322302.
Повний текст джерелаHyléen, Andrea, and Cecilia Lewin. "Sjuksköterskans upplevelser av ett rapid response system och dess påverkan på patientsäkerheten : en litteraturöversikt." Thesis, Sophiahemmet Högskola, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-2724.
Повний текст джерелаThe role of the emergency nurse is to provide immediate care to patients or to perform a nursing intervention that can prevent an emergency. They should lead, initiate and coordinate patient care. Factors that affect patient safety could be leadership, working in teams, evidence-based work, communication, training, or patient-centered work. Rapid response system (RRS) was developed to improve patient safety in emergency care. There are four units that are essential for the system to function. The afferent component includes the nurse who is responsible to identify warning signs if the patient is deteriorating and activate RRS. A track-and trigger system based on the patient’s vital signs is used to assist the nurse to identify deteriorating patients on wards. The most common vital signs in emergency care are: respiration, temperature, blood pressure, heart rate, consciousness and urine production. The efferent component is the relief effort that the afferent component calls for by activating RRS when abnormal vital signs are observed and generate a high score in the track-and trigger system. Alternatively, on the advice of the nurse's instinctive feeling that the patient's condition has deteriorated. The aim of this study was to highlight nurses' experiences of applying rapid response system in their work and illustrate its impact on patient safety. The method used was a literature review. Database searches were made in PubMed, CINAHL and Web of Science, which resulted in 16 articles being included in the study. Inclusion criteria used were English language, ’peer-reviewed’ and published in scientific journals between the years 2006-2016. An integrated analysis was used to find similarities and differences in the results. The result showed that RRS increased identification of critically ill patients, resulting in reduced number of cardiac arrests and unexpected deaths and led to more patients being moved to a higher level of care. Difficulties or limitations that emerged were inadequate skills, high workload and hierarchy. Abnormal vital signs were taken more seriously compared to "silent" changes. The nurses sometimes activated the system due to concerns based on their clinical experience, despite vital signs being normal. RRS was a help to manage critically ill patients and served as the hospital's Department 112. The emergency medical team mostly supported the nurses, but sometimes they experienced negative attitudes, which affected the future activations negatively. The conclusion of this literature review indicates that RRS for patient safety could help nurses in their daily work by promoting safe care. The nurse's experiences highlight the favorable circumstances and perceived difficulties with the RRS, which could be used for further research to develop the system.
Silva, Marcelo Ribeiro. "Aprendizagem nas organizações: uma análise de grupos multifuncionais de empresas do ramo automotivo." Universidade Presbiteriana Mackenzie, 2013. http://tede.mackenzie.br/jspui/handle/tede/793.
Повний текст джерелаFundo Mackenzie de Pesquisa
The objective of this thesis is to understand the learning processes that occur in crossfunctional groups in a perspective of Advanced Planning Product Quality (APQP) in automotive companies. The specific objectives seeks to identify and describe the constitution process of cross-functional groups and its relationship to learning; identify and describe the methodologies used inside cross-functional groups and its relationship to learning; identify, describe and discuss the factors that difficult the learning process inside cross-functional groups; identify, describe and discuss the factors that facilitate the learning process of crossfunctional groups and identify, describe and discuss the moments which there was evidence of group and collective learning. The theoretical framework proposed is designed of individual and collective learning developed by Nancy Dixon and team learning from the perspective developed especially in studies of Amy C. Edmondson and colleagues. The field research was developed in a qualitative, descriptive and interpretative way. It is also considered exploratory because the phenomenon of learning in work groups has been a topic that reveals little knowledge accumulated and systematized. Considering that research begins with a contextual-interpretive perspective, was proposed as the method qualitative case-study to observe, explore, interpret, understand and discuss issues related to learning processes. In order to achieve the proposed objectives and answer the research question, respondents were members of cross-functional groups of two distinct organizations (Alfa and Beta), three groups per company, totaling nineteen interviewees. Moreover, the non-participant observation is also a strategy to collect data. In order to structure, organize and analyze the data, was employed the templates analysis method, offered by Nigel King, that consist in the use of a priori codes derived from the theoretical framework. The results showed that, since there is psychological safety established, both team and collective learning occurs when the entire group, converging the members conflicts and discussions on consensus. Furthermore, the learning process is facilitated since the group constitution, mainly due to the mobility of its members, the manager's role as a catalyst of information, working methodologies employed in the two organizations, the Transitive Memory Systems, the "corridors", the practice of consulting the functional areas by its members, the existence of international forums, the actual physical arrangement of the companies surveyed, the moral support practiced in the core community, the investment of financial resources for the development of ideas members, the recognition of the expertise of the members, learning through practice of collective work, the willingness of participants to learning, among others. The indications for future studies encompass elements as macro-organizational culture and meso-organizational diversity and its influence on group learning, which are also limiting aspects of this research.
O objetivo desta tese é compreender os principais processos de aprendizagem que ocorrem em grupos multifuncionais de Planejamento Avançado da Qualidade do Produto (APQP) que atuam em empresas fornecedoras de autopeças. Os objetivos específicos buscam identificar e descrever o processo de formação de grupos multifuncionais e sua relação com a aprendizagem; identificar e descrever as metodologias utilizadas no funcionamento dos grupos multifuncionais e sua relação com a aprendizagem; identificar, descrever e discutir os fatores que prejudicam a aprendizagem dos grupos multifuncionais; identificar, descrever e discutir os fatores que facilitam a aprendizagem dos grupos multifuncionais e identificar, descrever e discutir momentos nos quais houve evidências de aprendizagem (grupal e coletiva) nos grupos multifuncionais pesquisados. O arcabouço teórico proposto está assentado na concepção de aprendizagem individual e coletiva desenvolvida por Nancy Dixon e na perspectiva da aprendizagem em nível grupal especialmente tratada nos estudos de Amy C. Edmondson e colaboradores. A pesquisa de campo foi desenvolvida em uma perspectiva qualitativa, de natureza descritiva e interpretativa. Considera-se também exploratória, pois o fenômeno da aprendizagem em grupos de trabalho tem sido um tema que revela pouco conhecimento acumulado e sistematizado. Considerando-se que a pesquisa parte de uma perspectiva contextual-interpretativa, foi proposto como método o estudo de caso qualitativo a fim de observar, explorar, interpretar, compreender e discutir aspectos relacionados aos processos de aprendizagem. Com a finalidade de se atingir os objetivos propostos e responder à pergunta de pesquisa, foram entrevistados integrantes de grupos multifuncionais de duas organizações distintas (Alfa e Beta), sendo três grupos por empresa, totalizando dezenove entrevistados. Além disso, a observação não participante também se constituiu em uma estratégia de investigação. Como forma de estruturar, organizar e analisar os dados utilizou-se os templates propostos por Nigel King - uso a priori de códigos obtidos a partir do referencial teórico. Os resultados mostraram que a segurança psicológica instaurada no âmbito grupal e coletivo, a aprendizagem ocorre quando o grupo inteiro consegue convergir seus conflitos e discussões internas em consensos. Além disso, o processo de aprendizagem é facilitado desde o momento em que o grupo é formado, principalmente devido à mobilidade dos seus membros, ao papel do gestor enquanto agente catalisador de informações, às metodologias de trabalho empregadas nas duas organizações, ao sistema artificial de Memória Transitiva, aos corredores , à prática de consultas às áreas funcionais pelos seus membros, à existência de fóruns internacionais, ao próprio arranjo físico das empresas pesquisadas, ao apoio moral praticado no ceio da coletividade, ao aporte dos recursos financeiros para o desenvolvimento das ideias, ao reconhecimento do conhecimento dos membros, à aprendizagem por meio da prática do trabalho coletivo, à predisposição para a aprendizagem dos participantes, entre outras. As indicações resultantes para estudos futuros abarcam elementos como cultura macro-organizacional e diversidade meso-organizacional e sua influência na aprendizagem do grupo, sendo estes também os aspectos limitadores desta pesquisa.
Edgren, Gustaf. "Blood donors' long-term health : implications for transfusion safety /." Stockholm : Karolinska institutet, 2007. http://diss.kib.ki.se/2007/978-91-7357-340-5/.
Повний текст джерелаReckhouse, William. "Optimisation of short term conflict alert safety related systems." Thesis, University of Exeter, 2010. http://hdl.handle.net/10036/3154.
Повний текст джерелаSouza, Aline Brenner de. "Cultura de segurança: avaliação das atitudes de segurança da equipe de enfermagem de um Hospital Geral de grande Porte de Porto Alegre." Universidade do Vale do Rio dos Sinos, 2016. http://www.repositorio.jesuita.org.br/handle/UNISINOS/6463.
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A partir da divulgação do relatório do Institute of Medicine, Errar é Humano, o tema segurança do paciente ganhou relevância e a prevenção de eventos adversos passou a ser uma preocupação da maioria das instituições de saúde. Dentro deste contexto, entende-se que as instituições consideradas “mais seguras” têm desenvolvida a cultura de segurança. A avaliação da cultura de segurança tem sido uma recomendação de órgãos certificadores e a utilização de instrumentos validados para esta avaliação é recomendada. O Safety Attitudes Questionnaire (SAQ) é um instrumento utilizado em diversas instituições. Objetivo: avaliar a cultura de segurança da equipe de enfermagem de uma Instituição privada de Porto Alegre e desenvolver e implantar plano de ação que busque o fortalecimento da cultura de segurança na Instituição. Método: estudo transversal, com abordagem quantitativa. Participaram do estudo 637 profissionais de enfermagem, sendo 198 enfermeiros e 439 técnicos e auxiliares de enfermagem, das áreas de internação e ambulatoriais da Instituição. As respostas ao questionário foram analisadas pelos domínios previstos na ferramenta do SAQ e consideradas positivas as pontuações acima de 75. Resultados: na média das respostas o resultado foi positivo para os enfermeiros (78 pontos) e os técnicos de enfermagem (76,1 pontos). Os domínios com resultados abaixo de 75 pontos foram o de “Percepção do Estresse” e “Condições de Trabalho” para ambas as categorias e, para os técnicos de enfermagem, a “Percepção da Gerência” também apresentou resultado abaixo de 75 pontos. Em relação a área de atuação, a terapia intensiva adulta foi a área que mais teve domínios com pontuação abaixo de 75 pontos e a maternidade apresentou resultado positivo em todos os domínios. Na avaliação da pontuação por questão, os piores resultados foram relacionados à percepção do cansaço e o impacto no atendimento a urgências, o quantitativo de profissionais e as falhas na comunicação. Como pontos positivos, destacaram-se a satisfação com o trabalho e a atuação da direção da Instituição. Conclusão: embora este estudo já traga diversos dados de acompanhamento e ações, sugere-se que sejam estendidos para os demais colaboradores médicos assistenciais da Instituição.
From the publication of the Institute of Medicine report, To Err is Human, the patient safety issue gained relevance and prevention of adverse events has become a concern of most health institutions. In this context, it is understood that the institutions considered "safer" have the safety culture developed. The assessment of safety culture has been a recommendation of certification bodies and the use of validated instruments for this assessment is recommended. The Safety Attitudes Questionnaire (SAQ) is a tool used in various institutions. Objective: To evaluate the safety culture of a private institution nursing staff of Porto Alegre and develop and implement action plan that seeks to strengthen the safety culture in the institution. Method: Cross-sectional study with a quantitative approach. Study participants were 637 nursing professionals, from which 198 were nurses and 439 nursing technicians and assistants, from the institutions hospitalization and ambulatory areas. Responses to the questionnaire were analyzed by the fields referred to in the SAQ tool and considered positive scores above 75. Results: the response average results was positive for nurses (78 points) and nursing technicians (76.1 points). Fields with results below 75 points were the perception of stress and working conditions for both categories, and nursing technicians perception of management also presented results slightly below 75 points. Regarding the area of operation, the adult intensive care was the area that had more areas with scores below 75 points and the maternity was positive in all areas. In the evaluation of the score by question, the worst results were related to perception of fatigue and the impact on the attending emergency cases, the amount of professionals and miscommunication. As positive points, job satisfaction and the institution’s executive committee performance can be highlighted. Conclusion: Although this study already brings various data monitoring and actions, it is suggested to be extended to other medical assistance employees of the institution.