Implementación de estrategias para el fortalecimiento de la cultura de seguridad del paciente en las sedes priorizadas de la ESE IMSALUD de la ciudad de San José de Cúcuta
Cargando...
Fecha
2021
Autores
Rincón Lizarazo, Adriana Patricia
Título de la revista
ISSN de la revista
Título del volumen
Editor
Ediciones Universidad Simón Bolívar
Facultad de Administración y Negocios
Facultad de Administración y Negocios
Resumen
Antecedentes: Establecer una atención segura y mantener estándares de calidad intrínsecos que garanticen la no ocurrencia de incidentes y/o eventos adversos, no es una tarea fácil, pues para generar el cambio se deben proponer políticas institucionales claras, sencillas y prácticas, además de inculcar el desarrollo y la aplicación de las mismas con el ejemplo (Ministerio de la protección Social, 2008), adicionalmente la política de seguridad del paciente es uno de los ejes del Sistema Obligatorio de Garantía de Calidad en Salud (SOGCS) constituido por un conjunto de elementos y mecanismos relacionados sistemáticamente que buscan mantener un óptimo nivel de calidad en los servicios prestados por las instituciones de salud en Colombia. (Ministerio de Salud y Protección Social, 2016). A nivel internacional en España, Mella y colaboradores (2020) determinaron la percepción de seguridad que tienen los trabajadores de la salud asistenciales y no asistenciales en un hospital universitario en donde hubo una participación del 35,36%, de los cuales el (32,3%) fue personal médico, con un (9%) de participación del servicio de urgencias, de los cuales el 86,4% tenia interacción con los usuarios, el 50% califico el clima de seguridad entre 6 y 8 puntos, el 82,8% no notificó ningún evento adverso en el ultimo año, en Colombia Martínez y colaboradores (2017) de la Corporación Universitaria Adventista de Medellín, determinaron en instituciones de salud de nivel I y II del departamento de Antioquia, la cultura de seguridad del paciente, incluyeron dentro de la evaluación a cuatro las IPS, los resultados muestran para para el hospital IV que el 66% de los participantes ofrecieron una puntuación entre 8 y 9 de 10, se identificaron fortalezas en las dimensiones de aprendizaje organizacional, apoyo de la gerencia, expectativas y acciones de la dirección y como oportunidades de mejora las dimensiones de dotación de personal y retroalimentación y comunicación, para el oriente colombiano, Camacho D (2020) de la Universidad Cooperativa de Colombia Seccional Santa Marta, realizo la medición de cultura de seguridad del paciente en la ciudad de Bucaramanga, en donde quienes ofrecieron mejores calificaciones fueron las mujeres y los profesionales de terapia ocupacional, fisioterapia y fonoaudiología, ninguna dimensión fue calificada como fortaleza o debilidad y se obtuvo una puntuación de 45%.
Objetivos: Diseñar e implementar estrategias para mejorar la apropiación y desarrollo de la cultura de seguridad del paciente en las sedes priorizadas de la ESE IMSALUD de la ciudad de San José de Cúcuta.
Materiales y Métodos: El origen de los datos es bibliográfico con diseño es de campo no experimental debido a que las variables no están sujetas a manipulación, para la medición de la cultura de seguridad del paciente, se utilizó el instrumento “encuesta de clima de seguridad” (Versión revisada y corregida tomada de la adaptación de la Encuesta de Clima de Seguridad propuesta por el AHRQ y adaptada por el Centro de Gestión Hospitalaria) (Ministerio de Salud y Protección Social, 2016) que consta de 52 preguntas cerradas, formuladas en positivo y algunas en negativo, dichas preguntas están agrupadas en segmentos dentro de los que se encuentran, las variables sociodemográficas, dos preguntas puntuales que miden el grado de cultura, y grado de reporte y 12 dimensiones de la cultura de seguridad del paciente.
Resultados: Se aplicó la encuesta de clima de seguridad del paciente a un total de 63 trabajadores que laboran en las sedes de Toledo plata, Domingo Pérez, San Martin, La floresta, Cundinamarca y Niña Ceci de la ESE IMSALUD de la ciudad de Cúcuta y su área rural, los resultados muestran un grado de cultura de seguridad del paciente de 90%, un 76% del personal no ha hecho ningún reporte de eventos adversos/errores/fallas o indicios de atención insegura en los pasados 12 meses, se resaltan fortalezas en las dimensiones de Expectativas y acciones de la dirección / supervisión de la unidad/servicio que favorecen la seguridad, aprendizaje organizacional - mejora continua y retroalimentación y comunicación sobre el error, que corresponden a puntajes de 76.5%, 89% y 79.3% respectivamente, las estrategias contempladas dentro del plan de mejoramiento para la mejora de la cultura de seguridad del paciente en las sedes priorizadas son dos: la primera denominada “VIERA” (Vigilancia de incidentes, Eventos adversos y reporte de acciones inseguras) y la segunda llamada “Siameses por la seguridad del paciente” que incluye una serie de actividades dirigidas a conocer el contexto de la seguridad del paciente, organización del tiempo para el desarrollo de las labores y el desarrollo de habilidades de comunicación, trabajo en equipo y autonomía institucional.
Conclusiones: Se observó que existen aún brechas importantes en las dimensiones de reporte de eventos adversos, la de personal y la de comunicación abierta, con puntajes de percepciones negativas de 76%, 25.75% y 20.33%, dimensiones que fueron intervenidas con el plan de mejora y las estrategias propuestas, el 100% del personal entrevistado a quienes se les pregunto si estaban satisfechos con el desarrollo de la actividad "HOY SIAMESES POR LA SEGURIDAD DEL PACIENTE", expresaron en sus respuesta que si estaban satisfechos y que les gustaría que este tipo de ejercicios se sigan desarrollando no solo con ellos sino en toda la ESE IMSALUD. En relación con el uso de la plataforma VIERA, se logró dar instrucciones al 100% del personal de las sede intervenidas, en cuanto a la ubicación, el manejo y el uso de los reportes
Background: To establish safe attention and maintain intrinsic quality standards that guarantee the non-occurrence of incidents and/or adverse events which is not an easy task. In order to generate change, simple and practical institutional policies must be proposed, in addition to promote the development and application of them with the example (Ministry of Social Protection, 2008), additionally the patient safety policy is one of the axes of the Obligatory System of Quality Guarantee in Health (SOGCS) constituted by a set of systematically related elements and mechanisms that seek to maintain an optimal level of quality in the services provided by health institutions in Colombia. (Ministry of Health and Social Protection, 2016). At the international level in Spain, Mella and collaborators (2020) determined the perception of security that care and non-care health workers have in a university hospital where there was a participation of 35.36%, of which the (32, 3%) were medical personnel, with a (9%) participation of the emergency service, of which 86.4% had interaction with users, 50% rated the safety climate between 6 and 8 points, 82.8% did not report any adverse event in the last year, in Colombia Martínez and collaborators (2017) of the Adventist University Corporation of Medellín, determined in level I and II health institutions of the department of Antioquia, the patient safety culture , included four IPS in the evaluation, the results show for hospital IV that 66% of the participants offered a score between 8 and 9 out of 10, strengths were identified in the organizational learning dimensions management support, management expectations and actions and as opportunities for improvement were identified the dimensions of staffing and feedback and communication. For eastern Colombia, Camacho D (2020) from the University Cooperativa de Colombia side Santa Marta, carried out the measurement of patient safety culture in the city of Bucaramanga, where those who offered better qualifications were women and occupational therapy, physiotherapy and speech therapy professionals, none dimension was qualified as strength or weakness and a score of 45% was obtained. Objectives: To design and implement strategies to improve the appropriation and development of the patient’s safety culture in the prioritized locations of ESE IMSALUD in the city of San José from Cúcuta. Materials and Methods: The origin of the data is bibliographic with a non-experimental field design because the variables are not subject to manipulation, for the measurement of the patient's safety culture, the instrument "safety climate survey" was obtained. ” (Revised and corrected version taken from the adaptation of the Safety Climate Survey proposed by the AHRQ and adapted by the Center for Hospital Management) (Ministry of Health and Social Protection, 2016) including 52 closed questions, formulated in positive and some other in negative, these questions are divided into segments where it can be found, sociodemographic variables, two specific questions that measure the degree of culture, and degree of reporting and 12 dimensions of the culture of patient safety. Results: The patient safety climate survey was applied to a total of 63 workers who work in the offices of Toledo Plata, Domingo Pérez, San Martin, La Floresta, Cundinamarca and Niña Ceci of the ESE IMSALUD of the city of Cúcuta and its rural area, the results show a patient safety culture of 90%, 76% of the staff have not made any report of adverse events/errors/failures or indications of unsafe attention in the past 12 months, strengths are highlighted in the dimensions of Expectations and actions of the management / supervision of the unit / service that favors safety, organizational learning - continuous improvement and feedback and communication about the error, which correspond to scores of 76.5%, 89% and 79.3% respectively, There are two strategies contemplated within the improvement plan in order to achieve better patient safety culture in the prioritized locations: the first called "VIERA" (Surveillance of incidents, Adverse events and reporting of unsafe actions) and the second called "Siamese twins for patient safety" which includes a series of activities aimed at knowing the context of patient safety, organization of time for the development of tasks and the development of communication skills, teamwork and institutional autonomy. Conclusions: As a conclusion it is determined there are still important gaps in the dimensions of reporting adverse events, personnel and open communication, with negative perception scores of 76%, 25.75% and 20.33%. Dimensions that were intervened with the improvement plan and the proposed strategies, 100% of the personnel interviewed who were asked if they were satisfied with the development of the activity " HOY SIAMESES POR LA SEGURIDAD DEL PACIENTE / TODAY SIAMESE FOR PATIENT SAFETY”, expressed in their answers that they were satisfied and that they would like this type of exercises continue to be developed not only with them but throughout the ESE IMSALUD. Regarding usage of the VIERA platform, it was possible to give instructions to 100% of the staff of the intervened headquarters, regarding the location, management and use of the reports
Background: To establish safe attention and maintain intrinsic quality standards that guarantee the non-occurrence of incidents and/or adverse events which is not an easy task. In order to generate change, simple and practical institutional policies must be proposed, in addition to promote the development and application of them with the example (Ministry of Social Protection, 2008), additionally the patient safety policy is one of the axes of the Obligatory System of Quality Guarantee in Health (SOGCS) constituted by a set of systematically related elements and mechanisms that seek to maintain an optimal level of quality in the services provided by health institutions in Colombia. (Ministry of Health and Social Protection, 2016). At the international level in Spain, Mella and collaborators (2020) determined the perception of security that care and non-care health workers have in a university hospital where there was a participation of 35.36%, of which the (32, 3%) were medical personnel, with a (9%) participation of the emergency service, of which 86.4% had interaction with users, 50% rated the safety climate between 6 and 8 points, 82.8% did not report any adverse event in the last year, in Colombia Martínez and collaborators (2017) of the Adventist University Corporation of Medellín, determined in level I and II health institutions of the department of Antioquia, the patient safety culture , included four IPS in the evaluation, the results show for hospital IV that 66% of the participants offered a score between 8 and 9 out of 10, strengths were identified in the organizational learning dimensions management support, management expectations and actions and as opportunities for improvement were identified the dimensions of staffing and feedback and communication. For eastern Colombia, Camacho D (2020) from the University Cooperativa de Colombia side Santa Marta, carried out the measurement of patient safety culture in the city of Bucaramanga, where those who offered better qualifications were women and occupational therapy, physiotherapy and speech therapy professionals, none dimension was qualified as strength or weakness and a score of 45% was obtained. Objectives: To design and implement strategies to improve the appropriation and development of the patient’s safety culture in the prioritized locations of ESE IMSALUD in the city of San José from Cúcuta. Materials and Methods: The origin of the data is bibliographic with a non-experimental field design because the variables are not subject to manipulation, for the measurement of the patient's safety culture, the instrument "safety climate survey" was obtained. ” (Revised and corrected version taken from the adaptation of the Safety Climate Survey proposed by the AHRQ and adapted by the Center for Hospital Management) (Ministry of Health and Social Protection, 2016) including 52 closed questions, formulated in positive and some other in negative, these questions are divided into segments where it can be found, sociodemographic variables, two specific questions that measure the degree of culture, and degree of reporting and 12 dimensions of the culture of patient safety. Results: The patient safety climate survey was applied to a total of 63 workers who work in the offices of Toledo Plata, Domingo Pérez, San Martin, La Floresta, Cundinamarca and Niña Ceci of the ESE IMSALUD of the city of Cúcuta and its rural area, the results show a patient safety culture of 90%, 76% of the staff have not made any report of adverse events/errors/failures or indications of unsafe attention in the past 12 months, strengths are highlighted in the dimensions of Expectations and actions of the management / supervision of the unit / service that favors safety, organizational learning - continuous improvement and feedback and communication about the error, which correspond to scores of 76.5%, 89% and 79.3% respectively, There are two strategies contemplated within the improvement plan in order to achieve better patient safety culture in the prioritized locations: the first called "VIERA" (Surveillance of incidents, Adverse events and reporting of unsafe actions) and the second called "Siamese twins for patient safety" which includes a series of activities aimed at knowing the context of patient safety, organization of time for the development of tasks and the development of communication skills, teamwork and institutional autonomy. Conclusions: As a conclusion it is determined there are still important gaps in the dimensions of reporting adverse events, personnel and open communication, with negative perception scores of 76%, 25.75% and 20.33%. Dimensions that were intervened with the improvement plan and the proposed strategies, 100% of the personnel interviewed who were asked if they were satisfied with the development of the activity " HOY SIAMESES POR LA SEGURIDAD DEL PACIENTE / TODAY SIAMESE FOR PATIENT SAFETY”, expressed in their answers that they were satisfied and that they would like this type of exercises continue to be developed not only with them but throughout the ESE IMSALUD. Regarding usage of the VIERA platform, it was possible to give instructions to 100% of the staff of the intervened headquarters, regarding the location, management and use of the reports
Descripción
Palabras clave
Cultura, Seguridad, Paciente, Encuesta, Culture, Safety, Patient, Survey
