Ciclo de melhoria para prevenção de quedas em unidade de pronto atendimento

Abstract

Introduction: Patient safety is directly associated with the quality of health services. In the context of Emergency Care Units, there are gaps in the implementation of safety protocols recommended by the National Patient Safety Program, such as the fall prevention protocol that results in damage in 30% to 50% of cases, among them the fractures. Objective: Carry out cycles of improvements for the prevention of falls in the UPA. Methodology: Experimental study, of the before and after type, with a concurrent time series and with a quantitative and qualitative approach, carried out in March 2022 and March 2023, at the UPA of Messejana, located in the city of Fortaleza, State of Ceará. For data collection, an instrument called safety walk was used, applied in axis two of the unit where patients remain accommodated on stretchers for more than 24 hours. The site has 16 beds for patients with a transfer request and awaiting regulation. Results: Comparing the results obtained during the study period, 61% and 83% of compliance with the safety walk requirements and the fall prevention goal were identified, respectively, with 14 samples in 2022 and five in 2023. requirement to carry out the assessment of the risk of falls on admission stratified by grade, we had 0% compliance in 2022 and 80% in 2023; regarding the daily assessment of the risk of falls stratified by degree, 0% compliance in 2022 and 100% in 2023; in the compliance requirement in the nursing prescription checked for care (keep the upper bed rails raised and wheels locked) we had 86% compliance in 2022 and 60% in 2023; in the requirement regarding the nursing prescription checked regarding care (guidance of the patient on the use of non-slip footwear), we went from 86% compliance to 80%; as for signaling for stratified fall risk, we went from 0% to 100% compliance; and as for the environment close to the patient, free of obstacles, illuminated and dry, we maintained 100% compliance in both years. Conclusions: The improvements made went far beyond the fall prevention protocol, which contributed to the strengthening of the safety culture in the institution, through practices included in the routine of the service, active surveillance and involvement of all employees, including management.