Gestão e segurança do paciente geriátrico em hospital público geral

Abstract

Adverse events (AEs) occur in all ages. The elder requires more hospitalizations, with longer length of stay associated with other diseases and daily consumption of several drugs, becoming more vulnerable to AEs. As the main purpose of this study was to analyze the patient safety incidents hospitalized geriatric patients, the strategy adopted was the single case study. Data collection was performed by means of document analysis based on information recorded in medical registries of 221 geriatric patients, aged 60 or older, admitted into the internal medicine infirmary of Mandaqui Complex Hospital, which is located in the North of São Paulo city, during 2014. Results obtained by this research may contribute to support public policies in the health managements, including female (52,9%), predominance of aged 80 to 89 years (41,6%) (p=0,017), presence of 16,3% of seniors with 90 years and more; diseases of the digestive system and circulatory system as a cause of hospitalization showing length of stay and number of AEs above the median for the total of patients; increase in the number of AEs with increasing the length of stay (p<0,0001); incidence rate of 0,61 AEs by patient/day, increasing with age (p<0,0001); presence of comorbidities in 91,4% of the patients and their close relationship with time of hospitalization and frequency of AEs (p=0, 012). The patient safety incidents were classified according to International Classification for Patient Safety (ICPS). We found 4752 incidents, 47,0% of these were of no harm and 53,0% classified as AEs. According to the degree of harm, 45,4% were mild, 47,8% moderate and 0,5% severe harm. In this study, all identified incidents were avoidable and their recognition make possible to plan health specific strategies for elders in different levels of patient health assistance.