RESUMO Objetivo: Mapear fatores internos e externos em uma unidade de emergência que interferem na prática comunicativa interprofissional. Método: Estudo de caso único realizado na unidade de emergência de um hospital geral. Os dados foram coletados por meio de observação participante, análise documental e entrevista semiestruturada, triangulados e submetidos à análise temática, a partir de categorias definidas a priori, baseadas na matriz SWOT. Resultados: Participaram 22 profissionais de saúde. Quanto aos pontos fortes e oportunidades, constatou-se que os profissionais compreendem a importância da comunicação como medida de segurança, utilizam a passagem de plantão e a comunicação escrita para compartilhar informações. Porém, a superlotação, a sobrecarga de trabalho, a ausência de padronização de condutas, a inexperiência de profissionais e o déficit no relacionamento interprofissional são fatores dificultadores de uma comunicação efetiva. Conclusão: O processo comunicativo interprofissional fragilizado dificulta a interação e o compartilhamento de informações para a tomada de decisões compartilhadas que possibilite a continuidade do cuidado de maneira segura.
Objective: To exam the association of the age-adjusted Charlson comorbidity index with the categories of risk classification, the clinical aspects, and the patient outcomes in the emergency department. Method: Cross-sectional, analytical study that analyzed the medical records of 3,624 patients seen in the emergency department. Charlson index scores greater than 2 showed a high rate of comorbidity (mortality risk). T-test and analysis of variance were applied in the analyses. Results: There was a significant difference between the Charlson comorbidity index and the risk classification, with higher scores found in patients classified in the white (2.57) and red (2.06) categories. Patients with vascular, endocrine, neurological, cardiologic, or device problems, and those who underwent a head tomography had a high rate of comorbidity. In addition, those admitted, transferred, or who died in the emergency room had significantly higher index scores compared to those who were discharged from the hospital. Conclusion: The high rate of comorbidity was associated with the categories of risk classification, main and nonspecific complaints, performance of a head tomography, and patient outcomes in the emergency room.
Review objective/questions:
The objective of this scoping review is to explore the existing literature on the evaluation of the quality of triage for patients of all ages and medical conditions in emergency departments (EDs).
The question for this review is: How is triage in the ED evaluated? More specifically, we are interested in answering the following sub-questions:
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