Adhesion to patient safety protocols in emergency care units

From April until September 2016, the exploratory stage of the action research was conducted on stratified sampling with 377 patients of eight units, with use of verification instrument of basic safety actions.

Results:

The absence of systematic identification of patients, fall risk assessment and signaling and development of pressure injuries were evidenced. We observed that 52.8% of parenteral solutions in use were not identified and that, in only 29.4% of the cases, the allergic condition was investigated. In 80.6% of the emergency units there was availability of alcoholic solution to hand hygiene.

Conclusion:

We concluded that the non-compliance of basic actions concerning patient safety exposes users to preventable adverse events and demands systematized actions to comply with government guidelines and promote quality of health assistance.

Descriptors:
Patient Safety; Emergency Medical Services; Health Care Quality; Checklist; Nursing

UPA^* * Emergency Care Unit;	Sector	Mean^ Monthly mean of treatments in the Emergency Care Units administered by the municipality of Curitiba/PR between April 2015 and March 2016.	%	Sample per UPA^* * Emergency Care Unit;	Sample per sector
A	Emergency	1046.3	35.88	51	18
	Hospitalization	481.4	16.51		8
	Observation	1388.4	47.61		24
Total UPA^* * Emergency Care Unit; A		2916.1	13.52
B	Emergency	1655.8	35.84	81	29
	Hospitalization	407.1	8.81		7
	Observation	2556.7	55.35		45
Total UPA^* * Emergency Care Unit; B		4619.5	21.42
C	Emergency	894.4	32.56	48	16
	Hospitalization	322.3	11.74		6
	Observation	1529.9	55.70		27
Total UPA^* * Emergency Care Unit; C		2746.7	12.74
D	Emergency	817.0	39.16	36	14
	Hospitalization	392.9	18.83		7
	Observation	876.3	42.01		15
Total UPA^* * Emergency Care Unit; D		2086.3	9.68
E	Emergency	936.4	52.63	31	16
	Hospitalization	291.8	16.40		5
	Observation	551.0	30.97		10
Total UPA^* * Emergency Care Unit; E		1779.1	8.25
F	Emergency	1024.6	49.52	36	18
	Hospitalization	335.3	16.20		6
	Observation	709.1	34.27		12
Total UPA^* * Emergency Care Unit; F		2068.9	9.59
G	Emergency	1081.3	39.13	48	19
	Hospitalization	489.7	17.72		8
	Observation	1192.3	43.15		21
Total UPA^* * Emergency Care Unit; G		2763.2	12.81
H	Emergency	985.5	38.16	45	17
	Hospitalization	755.3	29.24		13
	Observation	842	32.60		15
Total UPA^* * Emergency Care Unit; H		2582.8	11.98
Overall total		21562.5	100.00	377	377

	Variables	n	%
Sex
	Female	223	59.1
	Male	154	40.9
	Total	377	100
Age group
	18├60	171	45.4
	≥ 60	206	54.6
	Total	377	100
Sector
	Observation	169	44.8
	Emergency	147	39.0
	Hospitalization	61	16.2
	Total	377	100

Indicator	Observation		Emergency		Hospitalization		Total
Indicator	f	%	f	%	f	%	f	%
Patient identification
Yes	-	-	-	-	-	-	-	-
No	169	44.8	147	39.0	61	16.2	377	100
It does not apply	-	-	-	-	-	-	-	-
Total	169	44.8	147	39.0	61	16.2	377	100
Administration of drugs
Allergic patient
Yes	3	1.8	7	4.8	0	0	10	2.6
No	61	36.1	31	21.1	9	14.8	101	26.8
No information	105	62.1	109	74.1	52	85.2	266	70.6
Total	169	44.8	147	39.0	61	16.2	377	100
Identified allergen
Yes	2	1.2	5	3.4	0	0	7	1.9
No	1	0.6	2	1.4	0	0	3	0.8
It does not apply	166	98.2	140	95.2	61	100	367	97.3
Total	169	44.8	147	39.0	61	16.2	377	100
Identified infusions
Yes	17	10.1	64	43.5	41	67.2	122	32.4
No	128	75.7	60	40.8	11	18.0	199	52.8
It does not apply	24	14.2	23	15.6	9	14.8	56	14.8
Total	169	44.8	147	39.0	61	16.2	377	100
Risk of Fall
Degree of risk signaled
Yes	-	-	-	-	-	-	-	-
No	169	100	147	100	61	100	377	100
Total	169	44.8	147	39.0	61	16.2	377	100
Orientation regarding the risk
Yes	40	23.7	23	15.6	30	49.2	93	24.7
No	129	76.3	124	84.4	31	50.8	284	75.3
Total	169	44.8	147	39.0	61	16.2	377	100
Elevation of bed bars
Yes	-	-	107	72.8	30	49.2	137	36.3
No	-	-	39	26.5	27	44.3	66	17.5
It does not apply	169	100	1	0.7	4	6.6	174	46.2
Total	169	44.8	147	39.0	61	16.2	377	100
Risk of Infection
Available alcoholic solution
Yes	169	100	109	74.1	26	42.6	304	80.6
No	-	-	38	25.9	35	57.4	73	19.4
Total	169	44.8	147	39.0	61	16.2	377	100
Risk of pressure injury
Risk for injury
Yes	7	4.1	100	68	27	44.3	134	35.5
No	162	95.9	47	32	34	55.7	243	64.5
Total	169	44.8	147	39.0	61	16.2	377	100
Risk signaled
Yes	-	-	-	-	-	-	-	-
No	169	100	147	100	61	100	377	100
Total	169	44.8	147	39.0	61	16.2	377	100
Patient has injury
Yes	2	1.2	27	18.4	6	9.8	35	9.3
No	167	98.8	120	81.6	55	90.2	342	90.7
Total	169	44.8	147	39.0	61	16.2	377	100

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[1] CORRESPONDING AUTHOR: Danieli Parreira da Silva Stalisz da Paixão E-mail: d_enf@yahoo.com.br