Banca de DEFESA: CECILIA OLIVIA PARAGUAI DE OLIVEIRA SARAIVA

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
DISCENTE : CECILIA OLIVIA PARAGUAI DE OLIVEIRA SARAIVA
DATA : 25/09/2019
HORA: 14:00
LOCAL: Departamento de Enfermagem
TÍTULO:

EVALUATION OF NURSING SAFE CARE IN NEONATAL INTENSIVE CARE UNITS.

PALAVRAS-CHAVES:

Nursing. Patient safety. Neonatal Intensive Care Units. Watch out. Care Protocols.

PÁGINAS: 117
GRANDE ÁREA: Ciências da Saúde
ÁREA: Enfermagem
RESUMO:

The objective of this study was to evaluate safe nursing care in neonatal intensive care units. Evaluative research with quantitative approach, conducted in six hospitals in the metropolitan region of Natal / RN / Brazil. The study was subdivided into three methodological steps: 1) identification and mapping of Patient Safety in the Neonatal Intensive Care Unit, based on a scoping review; 2) elaboration of a safe care evaluation instrument, with subsequent validation of content and appearance; 3) evaluation of safe nursing care through a quasi-experimental, before-after study, with intervention. In step 1, a scoping review was performed in order to list the essential elements for safe nursing care. The construction of the assessment instrument (graphic protocol) of safe care (step 2) was based on the triad structure-process-result, with adaptations for neonatal care, supported by scoping review data. To validate the content and appearance of the graphic protocol, nurse judges were enrolled from a Lattes Platform search according to previously established inclusion criteria. The Delphi technique was used, divided into two steps (Delphi 1 and 2) and the validation process took place through an electronic form in Google forms. The relevance of the items was judged by the result of the Content Validation Coefficient. In step 3, for the measurement of safe care, a previously validated pre- and post-test instrument was used, interspersed with an intervention in the neonatal units. Data collection of this stage occurred from January to July 2019 through the non-participant observation of two trained evaluators and without interaction between them. The results were analyzed by descriptive statistics, thus the care classification was performed from the score listed in the graphic protocol. The Kappa coefficient was measured to assess interobserver agreement. All ethical precepts were respected and the project received approval from the Research Ethics Committee of the Federal University of Rio Grande do Norte, issued CAEE No. 64879717.4.0000.5537.Scoping review resulted in a total of 87 scientific productions, whose themes were subdivided into : Adverse Event Investigation (49; 56.3%) and Safe Practice Assessment / implementation (38; 43.7%). The construction of the protocol was based on these results. A structured checklist script was elaborated, consisting of ten items and 111 sub-items about the elements "structure, process and result". The protocol was considered valid for content, with Content Validity Coefficient of 0.97 in the second Delphi round. The overall estimate of the instrument for appearance validation was 0.99 at Delphi II. In addition, 100% of the judges recommended the use of the protocol after inclusion of suggested changes. In step 3, the process element presented the best compliance percentage, above 50% for all neonatal units. The process element varied so that those services that did not have the active patient safety center had their items considered inadequate (below 50% of compliance) in three services, in the first evaluation. The result element had the highest number of inadequacies (below 50% compliance in three intensive care units). In the metropolitan region of Natal, partially safe care prevailed, evidenced by 83.3% of NICUs with a protocol score between 7 and 13. It is concluded that, in the investigated services, nursing care is partially safe. Moreover, the evaluation, through the graphic protocol, was essential to identify problems that impact the safety of newborns. Similarly, the intervention played an important role in achieving improvements. However, it is necessary that these actions occur continuously to subsidize the practice of nursing professionals in the face of harm reduction.

MEMBROS DA BANCA:
Externa à Instituição - HELEN CRISTINY TEODORO COUTO RIBEIRO - UFSJ
Interna - 3168491 - NILBA LIMA DE SOUZA
Externa ao Programa - 1506238 - QUENIA CAMILLE SOARES MARTINS
Presidente - 1220598 - VIVIANE EUZEBIA PEREIRA SANTOS
Externo à Instituição - WILIAM WEGNER - UFRGS