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Qualidade dos cuidados prestados nos hospitais portugueses
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Introdução: A Qualidade na Saúde assume hoje um papel primordial sendo considerada “um imperativo moral, porque contribui para a melhoria da equidade e do acesso aos cuidados de saúde em tempo útil, da segurança e da adequação com que esses cuidados são prestados”(Direcção-Geral da Saúde [DGS], 2015, p.16), sendo aconselhado pela OMS implementar estratégias que visem a mesma, utilizando medidas que sejam sustentáveis a longo prazo (DGS,2015). Porém, para que o referido possa ser executado da forma mais eficiente e eficaz há que conhecer previamente a realidade, assumindo os enfermeiros uma posição privilegiada, pela essência da profissão, para avaliar a mesma. Objetivo: Descrever a perceção dos enfermeiros de serviços médico-cirúrgicos dos hospitais portugueses relativamente à qualidade dos cuidados prestados; Comparar a perceção dos enfermeiros de serviços médico-cirúrgicos dos hospitais portugueses relativamente à qualidade dos cuidados prestados com os resultados obtidos nos restantes países da europa. Material e Métodos: O estudo descritivo é quantitativo, observacional, transversal, envolvendo 2188 enfermeiros de unidades médico-cirúrgicas de adultos de 30 Hospitais portugueses. Os dados foram colhidos no âmbito do RN4Cast@pt, em 2013, usando questões integradas no Nurse Servey Instrument e tratados com recurso à estatística descritiva usando o programa SPSS. No que concerne ao estudo comparativo foram utilizados os dados apresentados por Aiken et al. (2012), os quais foram recolhidos através de um estudo transversal, entre 2009 e 2010, a 33659 enfermeiros de 488 hospitais de diferentes países Europeus como: a Bélgica, Inglaterra, Finlândia, Alemanha, Grécia, Irlanda, Países Baixos, Noruega, Polónia, Espanha, Suécia e Suíça. Resultados: Verificamos que 22,3% dos enfermeiros portugueses descrevem a qualidade dos cuidados de enfermagem prestados nos serviços como razoável/pobre, 28,7% está nada/pouco confiante relativamente à capacidade dos clientes para a gestão de cuidados após a alta, sendo que 53,5 % está nada/pouco confiante relativamente à forma como a direção hospitalar irá resolver os problemas relacionados com os cuidados aos doentes por si reportados. Relativamente à qualidade dos cuidados de enfermagem prestados nos serviços constatamos que Portugal integra a variação apresentada nos restantes países da Europa (min:11% na Irlanda; max:47% na Grécia) sendo a Polónia a que apresenta resultados mais próximos (26%) de Portugal. Porém, o mesmo não se verifica no que concerne ao grau de não confiança relativamente à capacidade dos clientes para a gestão de cuidados após a alta, e grau de não confiança relativamente à forma como a direção hospitalar irá resolver os problemas relacionados com os cuidados aos doentes reportados pelo enfermeiros, onde a variação é entre 74% (Polónia) a 28% (Suécia) e 87% (Grécia) a 58% (Alemanha), respetivamente. Discussão: Diferentes níveis de qualidade foram encontrados entre os países. Porém, a Grécia é o país que expressa de forma mais marcante esses dados, podendo este facto estar associado às dificuldades económicas pelo qual o sistema de saúde grego passa, não muito diferente da atualidade portuguesa, todavia apresentamos resultados bem melhores. Por outro lado, a melhor qualidade é percecionada na Irlanda e Noruega indo de encontro com o esperado pelo conhecido desempenho positivo dos sistemas de saúde. Consideramos que a população Portuguesa continua a ser crente na melhoria da panorâmica do sistema de saúde, aguardando que os decisores políticos façam algo para tal, tendo por base os resultados obtidos. Conclusões: A qualidade dos cuidados percecionada pelos enfermeiros de serviços médico-cirúrgicos de alguns hospitais portugueses é extremamente preocupante, sendo urgente o desenvolvimento de estratégias que invertam os resultados a curto prazo por parte dos decisores políticos. Verifica-se que somos uma população que continua a acreditar que algo poderá ser feito para melhorar a qualidade dos cuidados. Um leque amplo de literatura internacional sugere que melhorias ao nível do ambiente de prática de enfermagem poderá ser uma estratégia de baixo custo para melhorar a qualidade dos cuidados prestados.
Introduction: Quality in Health today plays a major role and is considered "a moral imperative, because it contributes to improving equity and access to health care in due time, the safety and suitability of when care is provided" (Direcção-Geral da Saúde [DGS], 2015, p.16), being advised by WHO to implement strategies to it, using measures that are sustainable in long term (DGS, 2015). However, that said can run as efficiently and effectively it is necessary first to know the reality, assuming nurses a privileged position, the essence of the profession to evaluate the same. Objective: Describe the perception of nurses of medical and surgical services in Portuguese hospitals on the quality of care; Compare the perception of nurses of medical and surgical services in Portuguese hospitals on the quality of care provided to the results obtained in other countries in Europe. Material and Methods: This descriptive study is quantitative and transverse, involving 2188 nurses in medical- surgical units of adults in 30 Portuguese hospitals. Data were collected under the RN4Cast@pt in 2013 using integrated questions in Nurse Survey Instrument and processed using descriptive statistics through SPSS program. Regarding the comparative study used the data presented in Aiken et al. (2012), which were collected through a cross-sectional study, between 2009 and 2010, 33659 nurses from 488 hospitals in different European countries such as Belgium, England, Finland, Germany, Greece, Ireland, Netherlands, Norway, Poland , Spain, Sweden and Switzerland. Results: We found that 22.3% of Portuguese nurses describe the quality of nursing care in services as reasonable / poor, 28.7% is nothing / little confident regarding the ability of customers to manage care after discharge, and that 53.5% is nothing / little confident as how the hospital management will solve the problems related to the care of patients by themselves reported. Regarding the quality of nursing care in the services we found that Portugal integrates the variation in the remaining European countries (min: 11% in Ireland; max: 47% in Greece) and Poland that presents the closest matches (26%) from Portugal. But the same is not true with respect to the degree of non- confidence in the ability of customers to manage care after discharge, and degree of non-confidence in the way the hospital management will solve the problems related to the care of patients reported by nurses, where the range is between 74% (Poland) 28% (Sweden) and 87% (Greece) to 58% (Germany), respectively. Discussion: Different quality levels were found between countries. However, Greece is the country that expressed more markedly this data, which may indeed be associated with economic difficulties by which the Greek health system passes, not unlike the Portuguese today, however well-presented better results. On the other hand, the best quality is presented in Ireland and Norway going against the expected by the known positive performance of health systems. We believe that the Portuguese population continues to be a believer in improving overview of the health system, waiting for policy makers to do something for it, based on the results. Conclusions: The quality of care presented by medical and surgical services of some Portuguese hospitals nurses is extremely worrying, being urgent to develop strategies to reverse the short-term results by policy makers. It appears that we are a population that continues to believe that something can be done to improve the quality of care. A wide range of international literature suggests that improvements in the nursing practice environment may be a low-cost strategy to improve the quality of care.
Introduction: Quality in Health today plays a major role and is considered "a moral imperative, because it contributes to improving equity and access to health care in due time, the safety and suitability of when care is provided" (Direcção-Geral da Saúde [DGS], 2015, p.16), being advised by WHO to implement strategies to it, using measures that are sustainable in long term (DGS, 2015). However, that said can run as efficiently and effectively it is necessary first to know the reality, assuming nurses a privileged position, the essence of the profession to evaluate the same. Objective: Describe the perception of nurses of medical and surgical services in Portuguese hospitals on the quality of care; Compare the perception of nurses of medical and surgical services in Portuguese hospitals on the quality of care provided to the results obtained in other countries in Europe. Material and Methods: This descriptive study is quantitative and transverse, involving 2188 nurses in medical- surgical units of adults in 30 Portuguese hospitals. Data were collected under the RN4Cast@pt in 2013 using integrated questions in Nurse Survey Instrument and processed using descriptive statistics through SPSS program. Regarding the comparative study used the data presented in Aiken et al. (2012), which were collected through a cross-sectional study, between 2009 and 2010, 33659 nurses from 488 hospitals in different European countries such as Belgium, England, Finland, Germany, Greece, Ireland, Netherlands, Norway, Poland , Spain, Sweden and Switzerland. Results: We found that 22.3% of Portuguese nurses describe the quality of nursing care in services as reasonable / poor, 28.7% is nothing / little confident regarding the ability of customers to manage care after discharge, and that 53.5% is nothing / little confident as how the hospital management will solve the problems related to the care of patients by themselves reported. Regarding the quality of nursing care in the services we found that Portugal integrates the variation in the remaining European countries (min: 11% in Ireland; max: 47% in Greece) and Poland that presents the closest matches (26%) from Portugal. But the same is not true with respect to the degree of non- confidence in the ability of customers to manage care after discharge, and degree of non-confidence in the way the hospital management will solve the problems related to the care of patients reported by nurses, where the range is between 74% (Poland) 28% (Sweden) and 87% (Greece) to 58% (Germany), respectively. Discussion: Different quality levels were found between countries. However, Greece is the country that expressed more markedly this data, which may indeed be associated with economic difficulties by which the Greek health system passes, not unlike the Portuguese today, however well-presented better results. On the other hand, the best quality is presented in Ireland and Norway going against the expected by the known positive performance of health systems. We believe that the Portuguese population continues to be a believer in improving overview of the health system, waiting for policy makers to do something for it, based on the results. Conclusions: The quality of care presented by medical and surgical services of some Portuguese hospitals nurses is extremely worrying, being urgent to develop strategies to reverse the short-term results by policy makers. It appears that we are a population that continues to believe that something can be done to improve the quality of care. A wide range of international literature suggests that improvements in the nursing practice environment may be a low-cost strategy to improve the quality of care.
Descrição
Palavras-chave
Enfermagem Medical and surgical services Nursing Portugal/Europa Qualidade dos cuidados Quality health care RN4Cast Serviços medico-cirurgicos
Contexto Educativo
Citação
Roque, S. M. B., Jesus, É. H., Araújo, B. R., & Almeida, S. P. (2016). Qualidade dos cuidados prestados nos hospitais portugueses. In M. M. Vieira, J. Neves-Amado, B. Araújo, & S. Deodato (Eds.), 10th International Seminar on Nursing Research proceedings (pp. 38-39). Universidade Católica Portuguesa.
Editora
Universidade Católica Portuguesa
Licença CC
Sem licença CC