Indicadores de qualidade da assistência de enfermagem em idosos

Abstract

The use of performance indicators is essential to the health services, especially in the area of nursing, once it is a measure that allows the monitoring and identification of strategies to intensify the improvement of quality of care. The objective of this study is to evaluate the quality of nursing care in elderly patients in a center of cardiovascular emergencies in a public hospital in the Federal District from the analysis and comparison of the proposed indicators by means of a validated instrument of Record of Active Search. The instrument consists of 12 quality indicators: 1 - identification of the hospitalized patient’s bedsides; 2 - risk to fall of the bed; 3 - identification of peripherals venous access; 4 - identification of post-infiltrative lesions; 5 - identification of equipment for intravenous infusion; 6 - identification of containers of whey and control of the speed of infusion; 7 - identification of gastric probes; 8 – setting of permanent vesical catheter and positioning of the bag collector of diuresis; 9 - checking of nursing procedures in the medical prescription; 10 – verification of the control of vital signs; 11 – checking the procedures in the prescription of nursing; and 12 - preparation of daily and complete prescription by nurses. We used two approaches: first, the qualitative, based on the Delphi Technique, with 17 nurses of the unit consulted for the improvement of the analysis in relation to the data collection instrument of indicators; then, we used a quantitative approach to measure and compare the proposed indicators for assessing the quality of nursing care. There were 258 patients and found several points that need intervention to improve the quality. It was pointed out that, among the 12 indicators, 06 received an Index of Ideal Conformity (IIC) less than that recommended; 03 indicators have no possibility of application due to the non-existence of Systematization of Nursing Care (SNC); and only 03 indicators with IIC recommended. It is necessary to improve and optimize the process of continuous education of the institution studied, to establish barriers of defense in order to avoid the mistakes and improve constantly the evaluative practices in the sense that the indicators show differences with the standard established as desirable and act as a call that identifies and directs attention to the key points of care that need to be reviewed.