Patient safety in the neonatal intensive care unit: nursing assessment according to the Donabedian model.
TL;DR
The Neonatal Intensive Care Unit was classified as a provider of partially safe care, with greater compliance in the Structure category, followed by the Outcome category, and lower performance in the Process category, highlighting weaknesses in the execution of care practices.
Abstract
Objective
To evaluate patient safety in the neonatal intensive care unit, according to the Donabedian model, considering the performance of the nursing team.
Method
Cross-sectional study. The sample consisted of 28 nursing professionals. Data collection was carried out through systematic observation, performed by two independent evaluators, using two instruments: the Patient Safety Assessment Checklist in the Neonatal Intensive Care Unit, which includes the dimensions of Structure, Processes, and Outcomes; and the Graphic Protocol. Descriptive statistics were applied for analysis, and the Kappa coefficient was calculated.
Results
The Kappa coefficient indicated a perfect degree of agreement between the evaluators (k=1). The overall assessment showed a conformity rate of 86.48%. The Structure category obtained 88.46%; Process reached 82.69%; and Outcome, 85.71%. The main deficiencies are concentrated in the dimensions of the care process, such as patient identification, communication with the family, and prevention of infections and falls.
Conclusion
The Neonatal Intensive Care Unit was classified as a provider of partially safe care, with greater compliance in the Structure category, followed by the Outcome category, and lower performance in the Process category, highlighting weaknesses in the execution of care practices.