Qualitative analysis of the use of the "evaluation of siderail use" instrument in a public emergency hospital
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Municipal Health Department of Rio de Janeiro, Brazil
Federal Fluminense University, Rio de Janeiro
National School of Public Health, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A919
Background and Objetive: The study is a partial result of a masters research in which an instrument was translated and cross-culturally adapted for one of the patient safety goals – risk of falls, whose protocols guide the use of siderails as safety devices in the prevention of falls among adults and the elderly hospitalized. The pre-test stage was analyzed, by nurses of a municipal hospital of the Unified Health System/Brazil. Methods: In the pre-test, 30 nurses applied the version approved to 57 hospitalized patients distributed across the internal medicine, cardiology, neurology, and orthopedics wards, 29 of whom were male, aged between 41 and 69 years. Each nurse carried out a subjective assessment of the indication for the use of side rails, followed by the indication using the translated instrument. Results: Neuropathies were the largest sample of patients to whom the questionnaire was applied (43.9%) followed by orthopedic patients (22.8%). The main subjective indication for the use of rails by nurses was “four” rails for 66.7% of cardiac/clinical patients and 48% of neuropathic patients. The highest proportion of indication for “four rails” was for women and the patients who had the lowest indication were polytrauma patients (0%), followed by general surgery patients (0%). Conclusions: When measuring the agreement between what the nurse judged subjectively and the patients preference for the use of rails, the highest correlations were presented in the item "no rail is indicated" and in the patients choice of "no rail". The study shows that independent patients with mobility and the ability to get out of bed agreed with the nurses assessment that no railing was necessary. However, patients with cognition and mobility restriction are difficult choices and require the use of an instrument for evaluation such as the one in the study. Keywords: Patient Safety, Sidedrails, Accidental Fall.