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Abstract(s)
No presente estudo procurámos descrever o ambiente de prática de enfermagem
nos serviços médico-cirúrgicos dos hospitais portugueses, bem como a perceção dos
enfermeiros sobre a qualidade e segurança dos cuidados aos clientes. Uma vez
conhecida a realidade, propusemo-nos ir mais além e desocultar as relações previstas
entre as variáveis, emergindo a questão de partida Qual o impacto do ambiente de
prática de enfermagem na qualidade e segurança dos cuidados prestados?
O estudo, estruturado segundo uma parte teórica, que fundamentou as hipóteses
levantadas, e outra parte empírica, foi transversal e analítico. Os dados foram
emergentes da replicação do projeto Nurse Forecasting in Europe (RN4Cast), em
Portugal.
Utilizámos a escala do ambiente de prática do índice de enfermagem, Practice
Environment Scale of the Nursing Work Index (PES- NWI), bem como diferentes
medidas associadas à qualidade e segurança dos cuidados prestados, do estudo do
RN4Cast.
O tratamento estatístico foi desenvolvido com recuso ao SPSS, realizando uma
análise descritiva, inferencial e preditiva. Modelos multinível ou por regressão
categorial foram criados para examinar o impacto do ambiente de pártica de
enfermagem na qualidade e segurança dos cuidados. A estrutura hierárquica, quando
possível, foi organizada em diferentes níveis: enfermeiro e serviço.
Integraram o estudo 2188 enfermeiros, de 130 serviços de 30 hospitais
Portugueses que consideraram o ambiente de prática de enfermagem desfavorável.
Diferentes medidas da qualidade dos cuidados prestados são classificadas de forma
preocupante, tal como as medidas associadas à segurança dos cuidados.
Um campo vago, associado à cultura de segurança, foi encontrado considerandose
o mesmo não promotor da identificação, da comunicação e da resolução de questões
de segurança.
A ocorrência de eventos adversos e incidentes com os enfermeiros, em Portugal,
identificada pelos enfermeiros é reduzida.
O ambiente de prática de enfermagem foi identificado como a única variável
independente que se constituiu sempre como significativa para as variáveis dependentes
em análise.
Os resultados sugerem-nos a necessidade de uma imediata intervenção ao nível
da qualidade do ambiente de prática de enfermagem pela significância que se
evidenciou neste estudo ao nível da qualidade e segurança dos clientes nas organizações
de saúde. Evidência que deve ser integrada nas práticas pelas decisões estratégicopolíticas
que fomentem ambientes de prática de enfermagem favoráveis e a
transparência dos mesmos.
In the present study we aimed to describe the nursing practice environment in medical and surgical services in the Portuguese hospitals, as well as the perception of nurses on the quality and safety of care to customers. Once the reality was known we aimed for deeper knowledge and to unveil the relationship between the variables provided. The starting question emerged: What is the impact of the nursing practice environment in the quality and safety of care? The study is structured in a theoretical part which supports the hypotheses, as well as an empirical part, being cross-sectional and analytical. Data were emerging trough the replication design Nurse Forecasting in Europe (RN4Cast) in Portugal. We used the scale of the practice environment of nursing index - Practice Environment Scale of the Nursing Work Index (PES NWI) as well as different measures related to quality and safety of care from the RN4Cast study. The statistical treatment was developed using SPSS, performing a descriptive, inferential and precictive analysis. Multilevel models or categorical were created to examine the impact of nursing practice environment quality and safety of care. The hierarchical structure, where possible, was organized in different levels: nurse and service. Study participants were 2188 nurses, from 130 services of 30 Portuguese hospitals which considered the unfavorable nursing practice environment. Different measures of quality of care are classified as alarmingly as well as the measures related to safety of care. A vacant field, associated to the safety culture was found and considered as nonpromoter regarding identification, communication and resolution of safety issues. The occurrence of adverse events and incidents involving nurses in Portugal, identified by nurses is low. The nursing practice environment was identified as the only independent variable that has always been significant to the dependent variables analyzed. The results suggest the need for an immediate intervention on the quality of nursing practice environment. The significance was evident in this study in terms of quality and customer safety in healthcare organizations. This evidence should be integrated into practices by strategic and political decisions that promote favorable nursing practice environments and more public transparence.
In the present study we aimed to describe the nursing practice environment in medical and surgical services in the Portuguese hospitals, as well as the perception of nurses on the quality and safety of care to customers. Once the reality was known we aimed for deeper knowledge and to unveil the relationship between the variables provided. The starting question emerged: What is the impact of the nursing practice environment in the quality and safety of care? The study is structured in a theoretical part which supports the hypotheses, as well as an empirical part, being cross-sectional and analytical. Data were emerging trough the replication design Nurse Forecasting in Europe (RN4Cast) in Portugal. We used the scale of the practice environment of nursing index - Practice Environment Scale of the Nursing Work Index (PES NWI) as well as different measures related to quality and safety of care from the RN4Cast study. The statistical treatment was developed using SPSS, performing a descriptive, inferential and precictive analysis. Multilevel models or categorical were created to examine the impact of nursing practice environment quality and safety of care. The hierarchical structure, where possible, was organized in different levels: nurse and service. Study participants were 2188 nurses, from 130 services of 30 Portuguese hospitals which considered the unfavorable nursing practice environment. Different measures of quality of care are classified as alarmingly as well as the measures related to safety of care. A vacant field, associated to the safety culture was found and considered as nonpromoter regarding identification, communication and resolution of safety issues. The occurrence of adverse events and incidents involving nurses in Portugal, identified by nurses is low. The nursing practice environment was identified as the only independent variable that has always been significant to the dependent variables analyzed. The results suggest the need for an immediate intervention on the quality of nursing practice environment. The significance was evident in this study in terms of quality and customer safety in healthcare organizations. This evidence should be integrated into practices by strategic and political decisions that promote favorable nursing practice environments and more public transparence.
Description
Keywords
Ambientes de prática de enfermagem Qualidade Segurança do doente RN4Cast Nursing practice environment Quality Patient safety