Readmissões hospitalares não planejadas após o acidente vascular cerebral na perspectiva de profissionais da saúde : descrição interpretativa

Abstract

Monitoring hospital readmissions is seen as a helpful indicator for assessing the quality of health care. In stroke cases, readmissions are frequent due to the complex demands that the patient will face throughout the continuum of care. The study of readmissions in stroke cases is essential for health professionals and institutions that work in the care of survivors and their family caregivers. Such information allows the redirection of efforts towards the management of safety and quality of transitional care after a stroke. This study aimed to understand health professionals' perspectives on the occurrence of unplanned hospital readmissions in stroke cases. It is a descriptive, interpretive study whose data were collected through semi-structured interviews. The participants were 18 health professionals who work in a hospital located in Goiânia, Goiás, Brazil. Through thematic interpretative analysis, thematic nuclei were identified: 1) Related factors and; 2) Strategies for preventing the occurrence of unplanned hospital readmissions in cases of stroke, from the perspective of health professionals. The participants attributed the occurrence of readmissions to the following factors: stroke complexity - disability, complications and unpreparedness of the patient and family, difficulties in maintaining rehabilitation; deficits in hospital discharge - early discharge and lack of planning; unilateral decision centered on the doctor; and organizational deficits - an overload of the team, lack of training for hospital discharge. In terms of strategies for preventing readmissions, they pointed out the need for a hospital discharge protocol centered on informational support and preparation for home care, patient and family involvement in discharge planning, and the integrated interdisciplinary team prepared for transitional care. Knowledge of these factors and strategies is essential to improve the quality of care, especially in stroke cases. It is a matter of inserting, in this process of instruction and education that constitute the protocol for discharge and transition of care, the culture of care, to reduce the gaps in this process as a whole, which will culminate in the reduction of readmissions unplanned hospital facilities