Quality of Care Indicators of a Pre-Hospital Mobile Emergency

Authors

  • Rodrigo Assis Neves Dantas Universidade Federal do Rio Grande do Norte
  • Daniele Vieira Dantas Universidade Federal do Rio Grande do Norte
  • Marina de Góes Salvetti Universidade de São Paulo
  • Isabel Karolyne Fernandes Costa Universidade Federal do Rio Grande do Norte
  • Gilson de Vasconcelos Torres Universidade Federal do Rio Grande do Norte
  • Kátia Regina Barros Ribeiro Universidade Federal do Rio Grande do Norte
  • Maria Marinah Souza do Nascimento Centro Universitário FACEX
  • José Eugênio Lopes Leite Serviço de Atendimento Móvel de Urgência do Rio Grande do Norte
  • Ana Paula Fernandes Leiros de Souza Hospital Monsenhor Walfredo Gurgel
  • Isabelle Cristina Braga Coutinho Cunha Estácio Ponta Negra/Mauricio de Nassau
  • Maria Solange Moreira de Lima Universidade Federal do Rio Grande do Norte
  • Rayane Araújo do Nascimento Universidade do Rio Grande do Norte
  • Kezauyn Miranda Aiquoc Universidade Federal do Rio Grande do Norte
  • Ellen de Fátima Lima Vasconcelos Universidade Federal do Rio Grande do Norte
  • Tiago Alves de Brito Universidade Federal do Rio Grande do Norte
  • José Joandson de Souza dos Santos Universidade Federal do Rio Grande do Norte
  • Sabrina Daiane Gurgel Sarmento Universidade Federal do Rio Grande do Norte
  • Sérgio Balbino da Silva Universidade Federal do Rio Grande do Norte
  • Izabelle Bezerra Costa Universidade Federal do Rio Grande do Norte
  • Izabelle Cristine Tarquinio de Carvalho Universidade Federal do Rio Grande do Norte

DOI:

https://doi.org/10.3823/2173

Keywords:

Quality Indicators; Health Care; Prehospital Care; Health Evaluation, Quality Indicators, Health Care, Prehospital Care, Health Evaluation

Abstract

Objective: To identify the quality of care indicators in pre-hospital mobile emergency services.

Methods and results: This study is a systematic review conducted in December/2015 in eight databases using the keywords: quality indicators in health care; pre-hospital care; and quality, access, and evaluation of the health care. Seventeen studies were selected and the following indicators were identified: conservation of the ambulances; physical structure; comfort in the ambulance; material resources; safety for the patient/professional; continuing education; response time; professional remuneration; professional/patient satisfaction; access; host; humanization; performed service; safety demonstrated by the team; privacy to the patient; guidelines on care; relationship between the professional/patient; opportunity of the patient to complaint.

Conclusion: The establishment the of the quality of care indicators the in mobile emergency services will allow the construction of instruments to evaluate this type of service to search for excellence results in mobile emergency services.

Author Biographies

Rodrigo Assis Neves Dantas, Universidade Federal do Rio Grande do Norte

Nurse. Ph.D. in Health Science/UFRN. Associate Professor of the Department of Nursing of the Federal University of Rio Grande do Norte (UFRN). Research group leader - Center for Studies and Research in Emergency and Intensive Care (NEPET/CNPq). 

Daniele Vieira Dantas, Universidade Federal do Rio Grande do Norte

Nurse. Post-Doctorate by the Post-Graduate Program in Nursing of the Federal University of Sergipe. Scholarship CAPES. Ph.D. in Nursing. Professor of the Department of Nursing of the Federal University of Rio Grande do Norte (UFRN). Deputy leader of the research group Center for Studies and Research in Emergency and Intensive Care (NEPET/CNPq).

Marina de Góes Salvetti, Universidade de São Paulo

Nurse. Post-Ph.D. in Nursing. Professor of the Department of Medical-Surgical Nursing of the Nursing School at the University of São Paulo.

Isabel Karolyne Fernandes Costa, Universidade Federal do Rio Grande do Norte

Nurse. Ph.D. student in Health Science/UFRN. Coordinator of the Continuing Education Center of SAMU 192 RN.

Gilson de Vasconcelos Torres, Universidade Federal do Rio Grande do Norte

Nurse. Post-Ph.d. in Nursing, Professor of the Department of Nursing at the Federal University of Rio Grande do Norte (UFRN).

Kátia Regina Barros Ribeiro, Universidade Federal do Rio Grande do Norte

Nurse. Ph.D. in Nursing by the Federal University of Santa Catarina. Associate Professor of the Department of Nursing and the University Hospital Onofre Lopes/UFRN.

Maria Marinah Souza do Nascimento, Centro Universitário FACEX

Student of the 7° period of the Nursing Graduation Course at UNIFACEX.

José Eugênio Lopes Leite, Serviço de Atendimento Móvel de Urgência do Rio Grande do Norte

Nurse. Master in Nursing/UFRN. Associate Coordinator of the Continuing Education Center of SAMU RN 192.

Ana Paula Fernandes Leiros de Souza, Hospital Monsenhor Walfredo Gurgel

Intensive Care Unit Nurse of the General Hospital Monsenhor Walfredo Gurgel.

Isabelle Cristina Braga Coutinho Cunha, Estácio Ponta Negra/Mauricio de Nassau

Nurse at the municipality of Natal/ Rio Grande do Norte. Professor and Coordinator of the Post-graduation in Health Area at Estácio Ponta Negra/Mauricio de Nassau. Specialist in Parasitology, Family Health, Urgency and Emergency, Obstetric Nursing and Audit of Health Systems.

Maria Solange Moreira de Lima, Universidade Federal do Rio Grande do Norte

Resident of the Multidisciplinary Program in Health in Cardiology area- HUOL/UFRN. Post-graduation in Pre-Hospital and Hospital Urgency and Emergency /Estácio.

Rayane Araújo do Nascimento, Universidade do Rio Grande do Norte

Nursing Student of the Federal University of Rio Grande do Norte (UFRN). Volunteer scholar and research group member of the Studies and Research in Emergency and Intensive Care (NEPET/CNPq). 

Kezauyn Miranda Aiquoc, Universidade Federal do Rio Grande do Norte

Nursing Student of the Federal University of Rio Grande do Norte (UFRN). Scholarship of the Dean of Research at UFRN (PROPESQ). Member of the Study and Research Center in Emergency and Intensive Care (NEPET/CNPq). 

Ellen de Fátima Lima Vasconcelos, Universidade Federal do Rio Grande do Norte

Nursing Student of the Federal University of Rio Grande do Norte (UFRN). Scholarship of the Dean of Research at UFRN (PROPESQ). Member of the Study and Research Center in Emergency and Intensive Care (NEPET/CNPq).

Tiago Alves de Brito, Universidade Federal do Rio Grande do Norte

Nursing Student of the Federal University of Rio Grande do Norte (UFRN). Volunteer scholar and research group member of the Studies and Research in Emergency and Intensive Care (NEPET/CNPq).

José Joandson de Souza dos Santos, Universidade Federal do Rio Grande do Norte

Nursing Student of the Federal University of Rio Grande do Norte (UFRN). Scholarship of the Dean of Research at UFRN (PROPESQ). Member of the Study and Research Center in Emergency and Intensive Care (NEPET/CNPq). 

Sabrina Daiane Gurgel Sarmento, Universidade Federal do Rio Grande do Norte

Nursing Student of the Federal University of Rio Grande do Norte (UFRN). Scholar of the Dean of Extension UFRN (PROEX). Member of the Study and Research Center in Emergency and Intensive Care (NEPET)/CNPq.

Sérgio Balbino da Silva, Universidade Federal do Rio Grande do Norte

Nurse. Infectiology Nursing Resident at the University Hospital Oswaldo Cruz/University of Pernambuco. 

Izabelle Bezerra Costa, Universidade Federal do Rio Grande do Norte

Nursing Student of the Federal University of Rio Grande do Norte (UFRN). Volunteer scholar and research group member of the Studies and Research in Emergency and Intensive Care (NEPET/CNPq).

Izabelle Cristine Tarquinio de Carvalho, Universidade Federal do Rio Grande do Norte

Nursing Student of the Federal University of Rio Grande do Norte (UFRN). Scholarship of the Dean of Research at UFRN (PROPESQ). Member of the Study and Research Center in Emergency and Intensive Care (NEPET/CNPq).

References

Blozik E, Nothacker M, Bunk T, Szecsenyi J, Ollenschläger G, Scherer M. Simultaneous development of guidelines and quality indicators – how do guideline groups act?: A worldwide survey. Int J Health Care Qual Assur [Internet]. 2012 [cited 2013 Jan 18];25(8):712-29. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23276064

Banerjea K, Carter AO. Waiting and interaction times for patients in a developing country accident and emergency department. Emerg Med J [Internet]. 2006 Apr [cited 2013 Jan 18];23:286-90. Available from: http://emj.bmj.com/content/23/4/286.long

Geraedts M, Selbmann HK, Ollenschlaeger G. Critical appraisal of clinical performance measures in Germany. Int J Qual Health Care [Internet]. 2003 Feb [cited 2013 Mar 18];15(1):79-85. Available from: http://intqhc.oxfordjournals.org/content/15/1/79.long

Donabedian A. An introduction to quality assurance in health care. Oxford: Oxford University Press; 2003.

Medeiros AJS, Nóbrega MM. Stress among professional nursing units service urgent and emergency: a review of literature. REBES [Internet]. 2013 Jul-Set [cited 2014 Jan 18];3(3):53-7. Available from: http://www.gvaa.com.br/revista/index.php/REBES/article/view/2499/1942

Vituri DW, Inoue KC, Bellucci Júnior JA, Oliveira CA, Rossi RM, Matsuda LM. Welcoming with risk classification in teaching hospitals: assessment of structure, process and result. Rev. Latino-Am. Enfermagem [Internet]. 2013 Oct [cited 2014 Jan 18];21(5):1179-87. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-11692013000501179&lng=en

Ministry of Health (BR). Order no. 2048, of November 5, 2002: approves the technical regulation of the state of emergency and emergency systems (pre-hospital care). Official Gazette, Brasilia (DF) 2002 nov 5; 219 Seção 1:32-54.

Ministry of Health (BR). Order no. 1864/03 of 29 September 2003: Establishes the mobile pre-hospital component of the National Attention to Emergencies Policy, through the Mobile Emergency Care Service implementation in municipalities and regions throughout Brazil: SAMU-192. Brasília (DF); 2003.

Bittencourt RJ, Hortale VA. Quality in the public health services emergency and some considerations about recent events at Rio de Janeiro city. Ciênc. saúde coletiva [Intenet]. 2007 Ago [cited 2010 Jan 18];12(4):929-34. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232007000400014&lng=en

Polit D, Beck C. Nursing research foundations: evaluation of evidence for nursing practice.7ª ed. Porto Alegre: Artmed; 2011.

Minayo MCS, Deslandes SF. Analysis of the implementation of a mobile pre-hospital treatment system in five Brazilian state capitals. Cad Saúde Pública [Internet]. 2008 [cited 2015 Dez 11];24(8):1877-86. Available from: http://www.scielo.br/pdf/csp/v24n8/16.pdf

El-Jardali F, Jamal D, Dimassi H, Ammar W, Tchaghchaghian V. The impact of hospital accreditation on quality of care: perception of Lebanese nurses. Int J Qual Health Care [Internet]. 2008 [cited 2010 Jan 18];20(5):363-71. Available from: http://intqhc.oxfordjournals.org/content/20/5/363.full.pdf

Munk MD, White SD, Perry ML, Platt TE, Hardan MS, Stoy WA. Physician Medical Direction and Clinical Performance at an Established Emergency Medical Services System. Prehosp Emerg Care [Internet]. 2009 Apr-Jun [cited 2010 Jan 18];13(2):185-92. Available from: http://informahealthcare.com/doi/abs/10.1080/10903120802706120?journalCode=pec

Dantas RAN, Costa IKF, Nóbrega WG, Dantas DV, Costa IKFC, Torres GV. Occurrences performed by the service of metropolitan emergency mobile attendance. Rev. Enferm. UFPE on line [Internet]. 2014 [cited 2015 Set 10];13(2):185-92. Available from: http://www.revista.ufpe.br/revistaenfermagem/index.php/revista/article/download/4077/8811

O'dwyer GO; Oliveira SP; Seta MH. Evaluation of emergency services of the hospitals from the QualiSUS program. Ciênc Saúde Coletiva [Internet]. 2009 Dez [cited 2010 Jan 18];14(5):1881-90. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232009000500030&lng=en

Dantas RAN, Torres GV, Salvetti MG, Dantas DV, Mendonça AEO. Instrument for assessing the quality of mobile emergency pre-hospital care: content validation. Rev Esc Enferm USP [Internet]. 2015 Ago [cited 2015 Set 12];49:381-7. Available from: http://www.scielo.br/scielo.php?pid=S0080-62342015000300380&script=sci_arttext&tlng=pt

Evans C, Howes D, Pickett W, Dagnone L. Audit filters for improving processes of care and clinical outcomes in trauma systems. Cochrane Database Syst Rev [Internet]. 2009 Oct [cited 2010 Jan 18];(4):CD007590. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007590.pub2/full

Luz CC, Junger WL, Cavalini LT. Analysis of prehospital care for stroke and acute myocardial infarction in the elderly population of Minas Gerais, Brazil. Rev Assoc Med Bras [Internet]. 2010 Jul-Aug [cited 2011 Jan 18];56(4):452-7 Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302010000400019&lng=en&nrm=iso&tlng=en

Souza ER, Correia BSC. Construction of indicators for assessing the policy of reducing accidents and violence for the elderly care. Ciênc Saúde Coletiva [Internet]. 2010 Set [cited 2011 Jan 18];15(6):2753-62. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232010000600013&lng=en

Al-Shaqsi S. Current challenges in the provision of ambulance services in New Zealand. Int J Emerg Med [Internet]. 2010 Dez [cited 2011 Jan 18];3(4):213-7. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3047887/

Siriwardena AN, Shaw D, Donohoe R, Black S, Stephenson J. Development and pilot of clinical performance indicators for English ambulance services. Emerg Med J [Internet]. 2010 [cited 2011 Jan 18];27:327-31. Available from: http://emj.bmj.com/content/27/4/327.full.html

Atack L, Maher J. Emergency medical and health providers’ perceptions of key issues in prehospital patient safety prehospital. Prehosp Emerg Care [Internet]. 2010 Jan-Mar [cited 2011 Jan 18];14(1):95-102. Available from: http://informahealthcare.com/doi/pdf/10.3109/10903120903349887

Stelfox HT, Bobranska-Artiuch B, Nathens A, Straus SE. A systematic review of quality indicators for evaluating pediatric trauma care. Crit Care Med [Internet]. 2010 Apr [cited 2011 Jan 18];38(4):1187-96. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20154596

El Sayed MJ. Measuring Quality in EmergencyMedical Services: A Review of Clinical Performance Indicators. Emergen Med Inter [Internet]. 2012 [cited 2013 Jan 18];161630:1-7. Available from: http://www.hindawi.com/journals/emi/2012/161630/

Snooks H, Anthony R, Chatters R, Cheung W, Dale J, Donohoe R et al. Support and assessment for fall emergency referrals (SAFER 2) research protocol: cluster randomised trial of the clinical and cost effectiveness of new protocols for emergency ambulance paramedics to assess and refer to appropriate community-based care. BMJ Open [Internet]. 2012 Nov [cited 2013 Jan 18];2(6):e002169. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3533098/

Leonard JC, Scharff DP, Koors V, Lerner EB, Adelgais KM, Anders J et al. A Qualitative Assessment of Factors That Influence Emergency Medical Services Partnerships in Prehospital Research. Acad Emerg Med [Internet]. 2012 Feb [cited 2013 Jan 18];19(2):161-73. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1553-2712.2011.01283.x/pdf

Von Kaufmann VF, Kanz KG. Die Rolle der Leitstelle im Prozess der präklinischen. Notfall Rettungsmedizin [Internet]. 2012 May [cited 2013 Jan 18];15(4):289-99. Available from: http://download.springer.com/static/pdf/828/art%253A10.1007%252Fs10049-011-1505-1.pdf?auth66=1403409707_cec4fd36795a333fc302f690be34c81d&ext=.pdf

Silva NC, Nogueira LT. Evaluation of operational indicators in a mobile emergency care Service. Cogitare Enferm [Internet]. 2012 Jul-Set [cited 2015 Set 15];17(3):471-7. Available from: http://ojs.c3sl.ufpr.br/ojs/index.php/cogitare/article/view/29287/19037

Malvestio MAA, Sousa RMC. Advanced life support: care provided to motor vehicle crash victims. Rev Saúde Pública [Internet]. 2002 Out [cited 2010 Jan 18];36(5):584-9. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102002000600007&lng=en

Morais AS, Melleiro MM. The quality of nursing care at an emergency unit: the patient’s perception. Rev Eletr Enf [Internet]. 2013 Jan-Mar [cited 2014 Jan 18];15(1):112-20. Available from: http://dx.doi.org/10.5216/ree.v15i1.15243

Donabedian A. La dimensión internacional de la evaluación y garantía de la calidad. Salud Publ Mex [Internet]. 1990 Mar-Abr [cited 2010 Jan 18];32(2):113-7. Available from: http://www.redalyc.org/articulo.oa?id=10632203

Ciconet RM, Marques GQ, Lima MADS. In-service training for health professionals of the Mobile Emergency Care Service: report on the experience of Porto Alegre, RS, Brazil. Interface (Botucatu) [Internet]. 2008 Set [cited 2010 Jan 18];12(26):659-66. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1414-32832008000300016&lng=en

Merhy EE. Saúde: cartography of live work in action. 3ª ed. São Paulo (SP): Hucitec; 2002.

Pereira DS, Araújo TSSL, Gois CFL, Gois Júnior JP, Rodriguez EOL, Santos V. Occupational stressors among nurses working in urgent and emergency care units. Rev Gaúcha Enferm [Internet]. 2013 [cited 2014 Jan 18];34(4):55-61. Available from: http://dx.doi.org/10.1590/1983-1447.2014.01.39824

Galvão CM. Levels of Evidence. Acta Paul Enferm [Internet]. 2006 [cited 2015 Set 13];19(2):V. Available from: http://www.scielo.br/pdf/ape/v19n2/a01v19n2.pdf

Downloads

Published

2016-11-10

Issue

Section

Anesthesiology & Emergency Medicine

Most read articles by the same author(s)

<< < 1 2