PATIENT SAFETY IN THE SCENARIO OF THE PSYCHIATRIC HOSPITAL
Patient safety; Risk management; Psychiatric hospital; Mental health.
The implementation of the Patient Safety Culture in health services and, more specifically,
within the psychiatric hospital, can become a strong ally in the fight for more humanized and safe care. In this perspective, patient safety is seen as an important device regarding more qualified psychiatric care. It is a qualitative research of the Convergent Assistance type. The general objective of this study was the construction of the patient safety protocol for a psychiatric hospital. For that, we sought to: identify the themes considered to be a priority for the team to develop the protocols; verify the theoretical supports that give basis to the themes worked; the definition of innovations necessary for the applicability of the protocols; and, knowing the perception of research participants about the patient safety culture. The investigation took place in a psychiatric hospital in the city of Natal/RN. The sample consisted of 18 professionals, which was made up of the care team – including the researcher who is also part of the hospital's technical team – and members of the management. Data collection occurred through face-to-face workshops, through the technique of discussion in a Convergence Group, using the Arco de Maguerez methodology. To analyze the data regarding the perception of the patient safety culture, the Collective Subject Discourse method was used. The results of this study were organized into three topics, namely: the characterization of the convergence group: the group was composed mostly of females, 13 (72.22%); predominantly aged between 31 and 40 years; regarding the academic level, 77.78% are specialists, however, only 1 participant reported having taken a course or postgraduate course in patient safety. The construction and presentation of the protocols: three products were built, namely: Interdisciplinary Assistance Protocol for Falls; Interdisciplinary Assistance Protocol for Evasion; and Interdisciplinary Assistance Protocol for Suicide. The conception of the convergence group about the culture of patient safety: five discourses of the collective subject were identified: “Patient safety and the global aspects of care”; “The culture of patient safety as a responsibility of all professionals and the institution itself”; “Patient safety contributes to quality psychiatric care. It positively influences the patient's emotions”; “The culture of patient safety as a habit that needs to be implemented and naturalized”; and “This is respect for life!”. The present study resulted in important developments for the implementation of protocols and the beginning of the implementation of the risk management culture, namely: the construction of the Adverse Events Notification Form and the Daily Fall Risk Assessment form; training of professionals regarding the application of protocols; training of the nursing staff regarding the use of the Morse Fall Scale; and training of professionals about suicide and about the management of patients with suicidal ideation. The use of a problematizing methodology and the collective construction process were essential for the team's adhesion in the construction and implementation of the products, and for the visualization and conduction of the developments resulting from this research.