Segurança do paciente nos procedimentos de reuso de capilares e linhas em hemodiálise

Abstract

Chronic renal failure (CRF) is a public health problem in Brazil. It presents high morbidity and mortality, and leads to dependence therapeutic treatment of renal replacement and, consecutively, the use of hemodialysis system, with the purpose of debugging undesirable substances. For hemodialysis treatment care is safe is necessary to build a patient safety culture in which professional services and share practices, values, attitudes and behaviors of harm reduction and promotion of safe patient care. Descriptive study developed in order to characterize the procedures that compromise the safety of the patient undergoing the dialysis treatment during system reuse. The study enrolled 110 patients who underwent the treatment of renal replacement in hemodialysis mode, in a city of Bahia Southwest region which meets the demand of 24 municipalities in the micro-region. For data collection was carried out direct observations were recorded in a checklist and semi-structured interviews with patients. The observation of the hemodialysis cycle and related procedures began from the patient's entry to the end of therapy and beginning of the system for reuse processing. We evaluated 110 patients participating in the process and hemodialysis systems, considering the maximum number of reuse, as recommended by ANVISA. From the analysis it was found that the hemodialysis system has been changed in a shorter period than allowed due to mechanical failure. These failures which consisted of heparin administration's delay in dialysis system with subsequent clotting system, as well as non-compliance with rules and regulations regarding the correct identification of the system and the patient. Such errors and mistakes possibilities, compromise patient safety, since the flaws and erroneous attitudes added nonadherence professional hand hygiene during patient care, interfere with the quality of care and safety thereof, which is exposed to the risk of infection and death. hemodialysis services should review the care processes and adopt behaviors and evidence-based practices that culminate in reducing adverse events and maximum patient safety. It is concluded that hemodialysis with the reuse of capillaries and lines, committed to patient safety and the data recorded in the survey indicate a cost-benefit ratio of less effective reuse indicating the need to evaluate the standardization system use to health, as single use, at the expense of compromising patient safety