Objetivo: Investigar si la percepción de la cultura de la seguridad de los pacientes quirúrgicos difiere entre los profesionales de enfermería y medicina que trabajan en una institución educativa pública brasileña. Método: Survey, estudio transversal realizado en un hospital en el sur de Brasil. El cuestionario Hospital Survey on Patient Safety Culture fue aplicado a 158 profesionales entre mayo y septiembre de 2017. Las 12 dimensiones se analizaron mediante estadísticas descriptivas e inferenciales y pruebas de coherencia interna. Las dimensiones con índices del 75% se consideraron reforzadas. Resultados: Hubo fragilidad en la cultura de seguridad, con un índice más bajo en la dimensión “Respuesta no punitiva al error”, con 23,9% y 13,9%, respectivamente, entre la enfermería y la medicina. Las puntuaciones más positivas fueron consideradas por la enfermería en ocho dimensiones, con diferencia (p<0.05) en relación con los profesionales médicos. Conclusión: La cultura de seguridad difiere entre las dos categorías profesionales, con respuestas más positivas por la enfermería; sin embargo, son necesarias acciones para fortalecer la seguridad de los pacientes quirúrgicos en ambos grupos profesionales. Objective: To investigate whether the perception of the surgical patient safety culture differs between nursing and medical professionals working in a Brazilian public educational institution. Method: Survey and cross-sectional study conducted in a hospital in southern Brazil. The Hospital Survey on Patient Safety Culture questionnaire was applied to 158 professionals between May and September 2017. The 12 dimensions were analyzed by descriptive, inferential statistics and internal consistency test. Dimensions with indexes ≥75% were considered strengthened. Results: There was fragility in the safety culture, with a lower index in the dimension “Nonpunitive response to error”, with 23.9% and 13.9%, respectively, between nursing and medicine. More positive scores were considered by nursing in eight dimensions, with difference (p<0.05) in relation to medical professionals. Conclusion: The safety culture differs between the two professional categories, with more positive responses by nursing; however, actions are necessary to strengthen the surgical patient safety in both professional groups Objetivo: Investigar se a percepção da cultura de segurança do paciente cirúrgico difere entre profissionais de enfermagem e medicina atuantes em instituição pública de ensino brasileira. Método: Survey e transversal conduzido em hospital da região sul do Brasil. Foi aplicado o questionário Hospital Survey on Patient Safety Culture a 158 profissionais entre maio e setembro de 2017. As 12 dimensões foram analisadas por estatística descritiva, inferencial e teste da consistência interna. Dimensões com índices ≥75% foram consideradas fortalecidas.Resultados: Evidenciou-se fragilidade na cultura de segurança, com menor índice na dimensão “Resposta não punitiva ao erro”, com 23,9% e 13,9%, respectivamente, entre enfermagem e medicina. Escores mais positivos foram considerados pela enfermagem em oito dimensões, com diferença (p<0,05) em relação aos profissionais médicos. Conclusão: A cultura de segurança difere entre as duas categorias profissionais, com respostas mais positivas pela enfermagem; porém demanda ações promotoras para fortalecer a segurança do paciente cirúrgico em ambos os grupos profissionais.

Objective: Reflect and propose adaptations to the Multimodal Hand Hygiene Strategy for field hospitals, in the context of the COVID-19 pandemic. Method: Reflective study, carried out in April 2020, based on the recommendations of the World Health Organization and the guide for the implementation of the five components of the Multimodal Strategy: system change related to infrastructure; training/education; evaluation and feedback; reminders in the workplace; and institutional security climate. Results: The Multimodal Strategy, proposed for hospitals in general, can be adapted for field hospitals in order to reduce the transmission of the SARS-CoV-2 virus. Investments to adapt the infrastructure and education of workers require foresight and speed and are of special relevance to promote hand hygiene in this care context. Final considerations: Adjusting the Multimodal Strategy, especially for the reduced time in the execution of each component, is necessary for field hospitals with a view to preventing COVID-19.

Objective: to identify the frequency and performance of the Canadian Adverse Events Study tracking criteria for the confirmation of surgical adverse events in adult patients. Method: a descriptive and retrospective study conducted in a public hospital in the state of Paraná from May to November 2017. A retrospective review of 192 medical records was conducted using 16 tracking criteria; and the confirmation of adverse events was in charge of a committee of experts composed of a physician and nurses. Data was analyzed by means of descriptive statistics. Results: the mean performance of the trackers was 73.3%. A total of 70 trackers were confirmed in 21.8% of the medical records with adverse events. The mean number of trackers was 0.4 per medical record (varying from zero to three). Adverse reaction to the medication; unplanned return to the operating room; unplanned removal, injury or correction of an organ or structure during surgery or invasive procedure; cardiopulmonary arrest reversed and hospital infection/sepsis were classified as high performance trackers (100.0%). Eight trackers did not contribute to the identification of adverse events. Conclusion: high-performance trackers can assist in detecting adverse events; there is potential to improve the tracking tool, contributing to its performance as a research method in Brazilian hospitals.

Objective: To identify the risk of pressure injury in patients of emergency care units. Method: Descriptive, cross-sectional, and quantitative by applying the Braden scale to 377 patients from eight units in Paraná, between April and September 2016. Descriptive statistics and Spearman's correlation were used, with a significance of 0.1% for analysis. Results: There was a prevalence of risk-free patients (64.5%; n=243) and of older adults (54.6%; n=206); those at high risk for pressure injury were in the emergency department. Most of the variables were preserved, with emphasis on sensory perception (65.3%; n=246). The Spearman's correlation coefficient was at least 0.93 and indicated a strong linear relation between the results obtained in the variables and in the scale; it was verified that the risk for pressure injury increases with age. Conclusions: Most of the patients were not at risk; however, the older adults and those treated in the emergency department were at high risk of developing pressure injuries.

Objetivo: identificar elementos que subsidiam a construção de protocolo clínico para detecção precoce de sepse em serviços de urgência e emergência. Método: revisão integrativa da literatura, do período de 2017 a junho de 2021, nas bases Medical Literature Analysis and Retrieval System Online, National Library of Medicine, Scientific Eletronic Library Online, Scopus e Web of Science. Resultados: foram encontrados 193 artigos e selecionados nove que compuseram a amostra final. Os elementos identificados foram: recomendações da campanha de sobrevivência à sepse; triagem e abertura de protocolo por enfermeiro; treinamentos; sistemas de alerta, uso dos critérios da síndrome da resposta inflamatória sistêmica; times de resposta ou gerente de protocolo; escore de alerta precoce; check-list de verificação; comunicação multiprofissional e lista de antibióticos. Conclusão: os resultados contribuem para assistência ao paciente séptico em serviços de urgência e emergência, favorecendo desfechos positivos, a partir do reconhecimento precoce e aplicação oportuna do tratamento inicial.