Omissão de cuidados de enfermagem e segurança do paciente em um hospital de referência: análise segundo instrumento Misscare-Brasil

Abstract

Omission of nursing care is the aspect of care required by a patient that is partially or completely omitted or significantly delayed. This is a construct related to the area of Patient Safety, also known as neglected, unfinished, lost, unfinished or rationed care.The objective was to investigate the phenomenon of omission of nursing care in a public hospital from the perspective of the team's professionals. Cross-sectional study carried out in a public teaching hospital, a reference in cardiology and pneumology in Ceará, between February and May 2023, with 85 professionals, nurses and nursing technicians from the adult and pediatric hospitalization units, intensive care and emergency. A sociodemographic/occupational instrument and the MISSCARE-BRASIL questionnaire were applied. Data were processed in the SPSS 23.0 program, submitted to descriptive, central tendency and dispersion analysis, presented in tables. The research followed the RANCARE guideline, which guides the writing of transparent reports of studies on unfinished nursing care. The project was approved by the Research Ethics Committee of the institution (Opinion no 5.466.795, CAAE: 59296022.2.0000.5039). Among the results, it was identified that 54.1% were technicians, mostly female, with an average age of 34 years, workload of 40 hours a week and 12 hours a day, working in a cooperative and experienced in the area and in the service. Participants positively evaluated the quality of care provided in their units (94.1%), as well as human (85.9%), material (76.5%), technological (74.1%) and team adequacy ( 64.7%). In addition, they were satisfied with the position/function (55.2%), the unit (58.8%) and individual performance in teamwork (61.2%), as well as not intending to leave the position/ function or professional area this year (85.9%). The omission of nursing care was identified with MISSCARE-BRASIL and the most prevalent were: Walking three times a day or as prescribed (62.4%), Sitting the patient out of bed (42.4%) and Participation in a discussion by the interdisciplinary team about patient care, if it occurs (36.5%). Among the main reasons for omission of care, it was identified:: Materials/Equipment did not work properly when necessary (71.8%), Materials/Equipment were not available when necessary (64.7%), Inadequate number of personnel for assistance or administrative tasks (61.2%), Urgent situations for patients (60.0%), Unexpected increase in the volume and/or severity of patients in the unit (60.0%) and Medications were not available when needed (60 ,0%). It is concluded that the participants revealed more reasons for omitting nursing care than the elements of

omitted care. However, omitted nursing care reported by more than half of the sample deserve special attention, as they can compromise patient safety, especially with regard to the development of pressure injuries, problems related to mobility, venous thromboembolism, increased length of hospital stay, among others. others. It is suggested, the continuation of this research focusing on observational studies, seeking to prove the most omitted care, its reasons and impacts generated on patient safety and professional satisfaction of the nursing team.