Adherence of the nursing team to patient safety actions in neonatal units

a cross-sectional study, carried out through direct observation of the nursing team and descriptive analysis of 182 records of the “Checklist for patient safety in nursing care during hospitalization in Neonatal Intensive Care Units” in a hospital in the municipality of Belo Horizonte.

Results:

there was evidence of adherence greater than 90.0% in the units concerning the use of the identification wristband and guidance of the companions. It was identified 79.0% of absence on the checking of wristband identification and 59.0% of the absence of an evaluation of the crib wheels’ locks. Three of the 21 items included in the checklist did not show non-conformities.

Conclusions:

partial adherence to patient safety actions was observed, especially regarding the target of patient identification and prevention of falls, which exposes newborns to preventable adverse events.

Descriptors:
Patient Safety; Checklist; Neonatology; Nursing, Team; Quality of Health Care

Observed items	NICU		NINCU
Observed items	n	%	n	%
Patient identification
Wristband affixed to one of the lower limbs, preferably having the mother's name and hospital registration number, legible.
Yes	109	90.1	61	100
No	12	9.9	-	-
Total	121	100	61	100
Data on the newborn's wristband checked with maternal data by double-checking with the father, or a companion or other health professional (in the absence of the father).
Yes	25	20.7	5	8.2
No	96	79.3	56	91.8
Total	121	100	61	100
Bed identification label with the bed number, newborn's name and mother's name.
Yes	83	68.6	60	98.4
No	38	31.4	1	1.6
Total	121	100	61	100
Effective communication
Companion instructed with accessible language concerning the unit's routine and an indication of hospitalization.
Yes	109	90.1	57	93.4
No	12	9.9	4	6.6
Total	121	100	61	100
Companion encouraged to be beside the newborn.
Yes	110	90.9	58	95.1
No	11	9.1	3	4.9
Total	121	100	61	100
Companion instructed about the care plan proposed for the newborn.
Yes	106	87.6	57	93.4
No	15	12.4	4	6.6
Total	121	100	61	100
Medication safety
Nursing professional instructed on the safe process of medication administration.
Yes	121	100	61	100
Total	121	100	61	100
Vascular catheters identified with the corresponding solution to the infusion and adjusted connectors.
Yes	74	61.2	-	-
No	43	35.5	3	4.9
Not applicable	4	3.3	58	95.1
Total	121	100	61	100
Infusion pumps and checked solution labels.
Yes	78	64.5	2	3.3
No	-	-	1	1.6
Not applicable	43	35.5	58	95.1
Total	121	100	61	100
Companion instructed about the medication therapy in use.
Yes	92	76	51	83.6
No	29	24	10	16.4
Total	121	100	61	100
Infection prevention
Nursing professionals aware of information about infection prevention related to health care.
Yes	121	100	61	100
Total	121	100	61	100
70% alcohol solution available at the bedside.
Yes	119	98.4	61	100
No	2	1.6	-	-
Total	121	100	61	100
Companion instructed about the risk of infection.
Yes	104	85.9	53	86.9
No	17	14.1	8	13.1
Total	121	100	61	100
Temperature and humidification of the incubator or crib suitable for gestational age and the newborn's need.
Yes	115	95	29	47.6
No	6	5	1	1.6
Not applicable	-	-	31	50.8
Total	121	100	61	100
Clean and well-adhered dressing.
Yes	61	50.4	6	9.8
No	21	17.4	-	-
Not applicable	39	32.2	55	90.2
Total	121	100	61	100
Fall and injury prevention
Crib or incubators wheels locked.
Yes	35	28.9	11	18
No	86	71.1	36	59
Not applicable	-	-	14	23
Total	121	100	61	100
Heated crib sides or locked doors.
Yes	91	75.2	29	47.5
No	30	24.8	20	32.8
Not applicable	-	-	12	19.7
Total	121	100	61	100
Companion instructed concerning NB fall prevention measures.
Yes	39	32.2	42	68.9
No	82	67.8	19	31.1
Total	121	100	61	100
Gastric tube and vascular device, ventilatory and/or monitoring devices positioned and fixed to prevent injuries.
Yes	83	68.6	52	85.3
No	38	31.4	-	-
Not applicable	-	-	9	14.7
Total	121	100	61	100
Nursing professionals are instructed on the NB's positioning, including the frequency of change in decubitus/pressure relief according to the clinical condition.
Yes	121	100	61	100
Total	121	100	61	100
Nursing professional instructed about the type and frequency of body hygiene.
Yes	121	100	61	100
Total	121	100	61	100

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
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[1] Corresponding author: Anna Caroline Leite Costa. E-mail: anna.leitebh@gmail.com