NURSES’ DECISION-MAKING REGARDING INCIDENTS RELATED TO PATIENT SAFETY

Abstract

This study aimed to analyze nurses’ decision-making regarding incidents related to patient safety. A documentary study was undertaken in a public hospital in Fortaleza, Ceará, between September and December 2014, analyzing records made in the Ward Notes (Livros de Ocorrência de Enfermagem). An association was ascertained between the variables of type of incident, professional category and degree of harm with the ameliorating actions implemented after the occurrence. Univariate and bivariate analysis was undertaken, applying the Pearson chi-squared test. It was observed that, of the 196 records found, only in 34.2% were the decisions made by the nurses described – the majority of these being directed towards the team and the patient. A significant statistical association was found between type of incident and documenting of ameliorating actions (p=0.000), emphasis being placed on those implemented in cases in which there was mild harm (24.4%) rather than serious harm. It is concluded that there is underreporting of incidents and decisions taken for mitigating them, indicating little recognition of either their importance or the harm to patient safety.

Keywords

• Nursing
• Patient safety
• Patient harm
• Nursing records
• Decision Making