Safety of patients with mental disorders: a collective construction of strategies

Abstract

Objective: to describe risk management implementation in the safety of patients with mental disorders through action research. Method: an action research carried out with a multidisciplinary team from a reference hospital in mental health in Southeast Brazil. Results: three strategies considered as managerial technologies for the mentally ill patient were developed: risk management diagram for patient safety; patient safety protocols; and textual proposal of software for internal management of incident notifications. Final considerations: this action research allowed a collective discussion by the whole multidisciplinary team, enabling strategy drafting for risk management implementation and improvement of care quality in the safety of patients with mental disorders at the study site.

A systematic review on the use of action research methods in mental health nursing care

“…The majority of the studies included in the review claimed to use either action research ( k = 4) (Chambers et al, 2013 ; Chandley et al, 2014 ; Crouche & Williamson, 2013 ; Hyde et al, 2009 ) or participatory action research ( k = 8) (Clements, 2012 ; Hutchinson & Lovell, 2013 ; Lange, 2011 ; Larkin et al, 2015 ; Moreno‐Poyato et al, 2019 ; Onnela et al, 2014 ; Salzmann‐Erikson, 2017 ; Vantil et al, 2020 ). Other studies also employed collaborative action‐research ( k = 1) (Lakeman & Glasgow, 2009 ), practitioner‐based action research ( k = 1) (Barrett & Roberts, 2010 ) and action research applying a cooperative inquiry perspective ( k = 2) (Borg et al, 2010 ; Kidd et al, 2015 ).…”

“…The category improving decision‐making procedures included those topics that sought to improve more specific aspects of mental health care and that responded to the attempt to structure and operationalize procedures for decision‐making. In this sense, risk management and assessment of mental health were dealt with in two studies (Crouche & Williamson, 2013 ; Vantil et al, 2020 ). Here, the contribution made by Crouche and Williamson ( 2013 ) stands out, by introducing a new risk assessment system in a community mental health team.…”

“…In this regard, the first aspect highlighted in all the articles was that the method made it possible to identify the meaning that the participants gave to the study phenomenon to be improved. Thus, in most cases, the participants' needs and priorities were identified (Barrett & Roberts, 2010 ; Chambers et al, 2013 ; Chandley et al, 2014 ; Hyde et al, 2009 ; Lakeman & Glasgow, 2009 ; Lange, 2011 ; Moreno‐Poyato et al, 2019 ; Vantil et al, 2020 ) together with the difficulties and barriers they encountered in practice (Barrett & Roberts, 2010 ; Chandley et al, 2014 ; Kidd et al, 2015 ; Moreno‐Poyato et al, 2019 ). Additionally, most of the studies described specific, adapted and efficient strategies to improve the topic of interest (Barrett & Roberts, 2010 ; Chambers et al, 2013 ; Chandley et al, 2014 ; Hyde et al, 2009 ; Larkin et al, 2015 ; Moreno‐Poyato et al, 2019 ; Onnela et al, 2014 ).…”

“…Participants felt more supported and relationships in the team were improved (Chambers et al, 2013 ; Lakeman & Glasgow, 2009 ; Moreno‐Poyato et al, 2019 ; Salzmann‐Erikson, 2017 ), involving managers (Crouche & Williamson, 2013 ; Hyde et al, 2009 ) and improvements in the consensus of objectives (Hutchinson & Lovell, 2013 ; Hyde et al, 2009 ; Moreno‐Poyato et al, 2019 ). In this sense, the process has been found to generate motivation and satisfaction (Chambers et al, 2013 ; Moreno‐Poyato et al, 2019 ; Vantil et al, 2020 ), providing security and empowering the participants in the project (Barrett & Roberts, 2010 ; Clements, 2012 ; Kidd et al, 2015 ; Moreno‐Poyato et al, 2019 ; Salzmann‐Erikson, 2017 ; Vantil et al, 2020 ).…”

Quality Diagnosis: Software para gestão de riscos em serviços de diagnóstico por imagem

“…Assim, há necessidade de mudanças nas práticas dos profissionais como a identificação de riscos assistenciais e físicos; mudança de cultura, estratégia e adesão dos trabalhadores da assistência; identificação do paciente; adoção de protocolos; comunicação eficaz; educação permanente e reuniões multiprofissional (Vantil et al, 2020;Farias, et al, 2018;Siman et al, 2016). Ainda, como recursos para potencializar a segurança do paciente, aponta-se para a importância de se manter processos educativos permanentes nos serviços e a utilização de tecnologias (Nora & Beghetto, 2020;Rodrigo et al, 2020;Lima Neto, et al, 2019).…”