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Previous issue date: 2016-08-19 === Os servi?os de sa?de t?m cada vez mais incorporado novas tecnologias e
t?cnicas acompanhadas de riscos adicionais ? seguran?a dos pacientes. Pacientes
internados em Unidade de Terapia Intensiva (UTI) est?o mais suscept?veis a erros.
Dentre as ferramentas utilizadas no mundo para reduzir a ocorr?ncia ou recorr?ncia
desses erros na assist?ncia ? sa?de, destacam-se a An?lise de Causa-Raiz (ACR) e
An?lise Modal de Falhas e Efeitos (AMFE). O objetivo do estudo foi identificar e
analisar a aplica??o das ferramentas ACR e AMFE para a melhoria da qualidade da
assist?ncia em UTI. Revis?o sistem?tica de literatura baseada no protocolo PRISMA.
Foram utilizadas as seguintes bases de dados: Scopus, PubMed, SciELO, LILACS,
Web of Science, Science Direct, Cochrane, WHOLIS, PAHO e EMBASE. A an?lise
qualitativa dos artigos foi realizada atrav?s da aplica??o de uma vers?o adaptada e
resumida do guia SQUIRE 2.0. Inclu?dos artigos originais indexados nas bases de
dados e que cumprissem 60% dos crit?rios do SQUIRE 2.0 adaptado. Foram
recuperados 1674 documentos nas buscas e, ap?s as an?lises pertinentes, foram
inclu?dos 18 artigos na revis?o. Desses, 16 foram publicados entre 2010 e 2016, 10
foram desenvolvidos nos Estados Unidos, 11 foram realizados em UTI Pedi?trica ou
Neonatal, 16 utilizaram AMFE em diversas tem?ticas, 13 realizaram interven??es
para melhoria da qualidade e desses, 12 utilizaram indicadores para medi??o da
melhoria relatando resultados positivos. Esses dados sugerem preocupa??o com o
planejamento da qualidade, sendo importante ressaltar a utiliza??o de indicadores
para medir a melhoria da qualidade na maioria dos estudos selecionados. Essa
revis?o refor?a a import?ncia do uso dessas ferramentas para a melhoria da
qualidade da assist?ncia nas UTI, permeando as institui??es de sa?de de
comportamentos que garantam mais seguran?a, contribuindo para o
desenvolvimento de uma cultura de seguran?a organizacional. === Health services have increasingly incorporated new technologies and techniques
accompanied by additional risk to patient safety. Patients in Intensive Care Unit (ICU)
are more susceptible to errors. Among the tools used in the world to prevent the
occurrence or recurrence of these errors in health care, we highlight the Root Cause
Analysis (RCA) and Failure Modes and Effects Analysis (FMEA). The objective of this
study was to identify and analyze the application of RCA and FMEA tools for
improving the quality of care in ICU. Systematic review of literature based on the
PRISMA. We used the following data bases: Scopus, PubMed, SciELO, LILACS,
Web of Science, Science Direct, Cochrane, WHOLIS, PAHO and EMBASE. The
qualitative analysis of the articles was conducted by applying an adapted and
abridged version of SQUIRE 2.0 guide. 1674 documents were recovered in searches
and, after the relevant tests, 18 were included in the review articles. Of these, 16
were published between 2010 and 2016, 10 were developed in the United States, 11
were conducted in the Pediatric ICU or Neonatal, 16 used FMEA on different topics,
13 performed interventions for improvement of quality and of those, 12 have used
indicators for measuring the improvement in reporting positive results. These data
suggest concern with quality planning, it is important to highlight the use of indicators
to measure the improvement of quality in most of the selected studies. This review
underscores the importance of using these tools to improve the quality of care in the
ICU, permeating the health institutions of behaviors that ensure more safety,
contributing to the development of an organizational safety culture.
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