This theoretical and reflexive study analyzed the risks related to the maintenance of patency of the Peripherally Inserted Central Catheter with the use of saline solution in comparison with saline-filled syringes, through the application of the Healthcare Failure Mode and Effect Analysis - HFMEA. The process was mapped, detailing the failure modes of each step. For the calculation of the Risk Priority Number, the severity and probability of the failure modes were analyzed. This analysis gave rise to the severity and probability matrix. Finally, actions to reduce the failure modes in the maintenance of patency were proposed, considering the use of saline-filled syringes in comparison to the use of saline ampoules. It was verified that the use of saline ampoules is associated with a greater risk, since it requires four stages more than saline-filled syringe does not, increasing the risk of contamination and the level of three different risks, which would result in additional hospital costs. The use of the saline-filled syringe would avoid risks that could negatively affect the patient’s health, the nursing professional and the health institution.

Demographic and epidemiological changes require different healthcare management systems to treat chronic diseases, rather than acute illnesses with short-term costs. This scenario, added to the technological advances in medicine, contributed to the beginning of a global crisis in healthcare that forces improvements in cost and quality management. Therefore, this article aims to provide an overview of the research related to the impact of performance-related payment models in healthcare quality, through a bibliometric study. The adopted methodological approach mixes techniques of bibliometrics, keyword networks, co-authorship and co-citation networks and content analysis. The results show a stability in the number of publications in the past years, with a concentration of scientific production in the United States and the United Kingdom and in the field of medical knowledge. In Brazil, the issue is still nascent and represents an important gap to be explored, as well as studies that prove the long-term outcomes and the sustainability of the quality improvements after the removal of the incentive.

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