Ciclo de melhoria na adesão ao protocolo de queda do paciente em unidade cirúrgica

Abstract

Introduction: the incident of falling in hospitalized patients requires attention from professionals due to its ability to worsen the clinical condition, which can result in death. 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 an improvement cycle to increase the fall prevention indicator in the surgical clinic unit in a public hospital in Pernambuco/Brazil. Methodology: Based on a quality improvement cycle, a quasiexperimental, before and after, quantitative study was developed, without a control group, carried out in the 2021/2022 biennium, following the Standards for Quality Improvement Reporting Excellence 2.0 (SQUIRE) guidelines. For the proposed evaluation, a quality criterion was defined related to the causes of non-adherence to the patient's fall prevention protocol in a surgical unit of a public hospital. Interventions were planned and implemented in a participatory and multifaceted way, based on data and with the objective of increasing the adherence of the health team to the fall prevention protocol. The ethical precepts of Resolutions No. 466/12, 510/16 were preserved. Results: The initial evaluation showed 76% of non-compliance regarding the filling out of the Morse scale and the assessment of the risk of falling by the nurses of the surgical clinic and that the median of the monthly measurements of the rate of falls was 0%. After the intervention, the reassessment showed that there was 36% of non-compliance regarding the completion of the Morse scale of patients admitted to this sector, representing a 40% reduction in non-compliance regarding the completion of the Morse scale. The median drop rate moved to 0.35% and then to 0.08%, where it has remained since. Conclusions: It is inferred that the improvement cycle carried out in this study represents a valuable tool to intensify quality management, as it contributed to a relative improvement of 40% in compliance regarding the completion of the Morse scale and the assessment of the risk of falling by the Surgical clinic nurses. Based on the results achieved, the institution can disseminate important contributions to other hospitals in the public health network, by demonstrating the planned interventions with the help of quality tools, which can more accurately identify opportunities for improvement, increasing the chance success in solving the quality problems found and favoring the improvement of patient care.