IMPROVEMENT CYCLE TO INCREASE ADHESION TO PATIENT SAFETY PRACTICES IN THE SURGICAL UNIT OF A PUBLIC HOSPITAL
Patient safety. Quality improvement. Results assessment. Health care. Health education
Introduction: Safe care is a challenge for health services during the care process and in promoting actions to improve the quality of care. The World Health Organization (WHO) estimates that tens of thousands of people each year suffer unnecessary harm from unsafe care. In Brazil, more than 30,000 thousand incidents related to health care were registered in the period from April 2020 to March 2021. The fall incident in an inpatient requires attention from professionals due to its ability to worsen the clinical condition, which may result in death. Fall is the unintentional displacement of the body to a level below the starting position, caused by multifactorial circumstances, resulting in damage or not. When prevention and monitoring measures are adopted, this risk is minimized, this study is based on safety practices in the hospital context. Objective: to carry out a cycle of improvement to increase the fall prevention indicator in the surgical clinic unit in terms of good patient safety practices in a public hospital in northeastern Brazil. Methodology: Quasi-Experimental Study, type before and after, quantitative approach, following the guidelines of the Standards for Quality Improvement Reporting Excellence 2.0 (SQUIRE). To identify the opportunity for improvement, the nominal group technique will be applied to establish the main problems, then the causes listed in a prioritization matrix, with the low adherence of professionals to safety practices in the care of surgical patients being the priority problem. The causes will be studied through the Ishikawa Diagram and upon analysis a quality criterion will be established, which improvement after interventions will be studied. The criteria will be: assessment of the risk of falling within the first 24 hours of admission, collection from medical records randomly selected in periods before, during and after the intervention through verification of completion of the standardized instrument by the institution. All criteria must have a level of agreement above 95%, and will be acceptable in the Kappa index with indexes above 0.9. The knowledge of professionals regarding the MORSE scale and its applicability will be measured through a questionnaire built by the researcher and intervention workshop for training nurses with a sample forecast of 12 participants. The ethical precepts of resolutions 466/12, 510/16 and 580/18 will be preserved. Expected results: It is believed that interventions planned with the help of quality tools will provide a more accurate identification of opportunities for improvement, increasing the chance of success in solving the quality problems found and favoring better patient care.