La investigación de incidentes y eventos adversos como herramienta para mejorar la cultura de seguridad de pacientes

Resumo

Background: Patient safety culture is an essential step to quality and safety in health care. Objective: To evaluate the effectiveness of an educational intervention to improve patient safety culture in the Teaching Units of Family and Community Medicine of Galicia. Method: Unifactorial experimental study of two groups, control and intervention, carried out in these teaching units. SOPS questionnaire was sent to all residents of fourth years and their tutors. Those who agreed to participate were randomized. The intervention group received specific training, recorded incidents for 15 days with the questionnaire APEAS and subsequent feedback. In the control group, no action was performed. After the intervention, the questionnaire was sent to all participants. Protocol approved by the Ethics Committee for Clinical Research of Galicia. Results: The participation rate was 58.7% and 45 physicians reported incidents. The intervention has independent effect on Patient Safety Grade, 0.278 (0.153 to 0.395) with p = 0.021. In the Number of Incidents Reported, it was positive with RRR = 27.82 (2.89 to 267.77) in the notification of 3 or more. The main causal factors involved in the incidents are communication and medication. Conclusion: The educational intervention proposed in the Teaching Units of Family Medicine and Community of Galicia is effective in improving the safety culture.