Experiencia de enfermeros en relación con la seguridad del paciente en la atención prehospitalaria móvil

Filipe, Eduardo Dias; Modesto, Roberto Chrispim; Carmo, Hercules de Oliveira; Martins, Haviley Oliveira; Martins, Maristela Santini

doi:10.1590/0034-7167-2023-0529

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 77 (5) • 2024 • https://doi.org/10.1590/0034-7167-2023-0529 linkcopiar

Experiencia de enfermeros en relación con la seguridad del paciente en la atención prehospitalaria móvil

Autoría SCIMAGO INSTITUTIONS RANKINGS

Objetivos: comprender la experiencia de enfermeros en relación con la seguridad del paciente en la atención prehospitalaria móvil.

Métodos: estudio cualitativo, exploratorio y descriptivo, realizado con enfermeros actuantes en servicios de atención prehospitalaria móvil. Se realizaron entrevistas semiestructuradas, audiogravadas y sometidas al análisis de contenido de Bardin.

Resultados: a partir de cuatro categorías temáticas establecidas, los enfermeros informaron las habilidades de atención y gestión necesarias para actuar en este servicio. Demostraron un compromiso para garantizar una atención segura para los pacientes, el personal y los espectadores. Destacaron las acciones tomadas para prevenir y mitigar incidentes. Sin embargo, basaron sus experiencias en protocolos de práctica y acciones individuales, expresando la necesidad de mejorar el conocimiento sobre la seguridad del paciente.

Consideraciones Finales: la experiencia de los enfermeros que actúan en la atención prehospitalaria móvil en relación a la seguridad del paciente ha sido limitada, sugiriendo la necesidad de capacitación en el tema, alineación de procesos de trabajo e implementación de estrategias, con el objetivo de garantizar una atención segura.

Descriptores:
Seguridad del Paciente; Servicios Médicos de Urgencia; Grupo de Atención al Paciente; Unidades Móviles de Emergencia; Enfermeras y Enfermeros

Patient safety measures	Actions performed by nurses in mobile pre-hospital care
Correct patient identification	In general, we first confirm patient identification by asking their name and checking documentation. In other situations, when the victim is unknown and does not have personal data, we identify them by describing their age, sex and clothing characteristics. (E7) Regarding patient identification, we have two types of patients: conscious and unconscious. We always ask the conscious person their name before carrying out any procedure. (E8) The first thing we do with patient safety and goals in mind is to try to identify who the victim is. (E13)
Clear and assertive communication between professionals and healthcare services	We always exchange information with the doctor as a safety measure. (E8) The regulation center reports an incident, but we will only really know what is happening when we arrive at the scene. This situation causes a certain insecurity and difficulty because we don’t know what we are going to find. (E4) At the hospital, really passing on case information effectively. Try to ensure that all data that was collected at the scene reaches the destination location. (E12)
Injury and fall prevention	If you need to puncture patients, we normally try to do it assertively. If, on the first attempt, you are unable to do it, do not keep trying several times, to avoid other injuries related to the venipuncture technique. (E11) We advise on the correct way to handle the ambulance stretcher, “lowering it to the floor”, as it poses a risk to patients. (E6) When transferring patients to another service, it is noted that they spend a long time on our stretchers due to lack of beds, and this has caused falls. Now we are leaving the stretchers lowered to the floor. I think we have to pass this information on to nursing assistants and technicians at our workplace too, so they can be careful so patients don’t have the risk of falling. (E10)
Safe medication administration	Regarding medication, for instance, we always check medication validity and some equipment that also have a pre-determined maintenance date at the beginning of the shift. (E6) We confirm if you have a drug allergy and underlying illnesses. (E7) If the doctor tells us to take medication, we first confirm the prescription [drug, route, dosage] and then double-check it before administering it. (E8)
Infection control	Every procedure begins with the use of personal protective equipment. We have to use PPE to preserve our safety. (E4) If you puncture a venous access and do not fix it correctly, the catheter will probably come out, so you will expose patients to a new invasive and risky procedure. (E14)

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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
E-mail: reben@abennacional.org.br

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