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      Segurança do paciente e códigos deontológicos em Beauchamp e Childress Translated title: Patient safety and deontological codes in the context of Beauchamp and Childress Translated title: Seguridad del paciente y códigos deontológicos en Beauchamp y Childress

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          Abstract

          Resumo A segurança do paciente é questão persistente de saúde pública e tem assumido nova conotação no contexto sanitário contemporâneo. Beauchamp e Childress, na obra pioneira “Principles of biomedical ethics”, abordam a atuação ética dos profissionais de saúde e a influência dos códigos deontológicos na segurança do paciente. Nesse sentido, este estudo procura demonstrar que esses códigos são insuficientes para atender a todos os dilemas éticos e morais relacionados à segurança do enfermo na atualidade. Assim, propõe-se que esse tema não seja somente discutido em conselhos de ética da área da saúde, mas também em comitês interdisciplinares de bioética clínica e assistencial, proporcionando exercício mais ampliado e concreto de reflexão bioética.

          Translated abstract

          Abstract Patient safety is a persistent issue in public health that has taken a new connotation in the contemporary sanitary context. Beauchamp and Childress, in their pioneering work, Principles of Biomedical Ethics, address the ethical role of health professionals and the influence of deontological codes on patient safety. The present study seeks to demonstrate that codes of ethics are insufficient to address all ethical and moral dilemmas related to patient safety at present. In this sense, it is proposed that this topic should not be discussed only in the ethics councils of the different professions in the health area, but that the dialogue be extended to the interdisciplinary committees of clinical and healthcare bioethics, providing a broader and concrete exercise of bioethical reflection.

          Translated abstract

          Resumen La seguridad del paciente es una cuestión persistente en salud pública y ha asumido una nueva connotación en el contexto sanitario contemporáneo. Beauchamp y Childress, en la obra “Principles of biomedical ethics”, abordan la actuación ética de los profesionales de la salud y la influencia de los códigos deontológicos en la seguridad del paciente. En ese sentido, este estudio procura demostrar que los códigos deontológicos son insuficientes para atender a todos los dilemas éticos y morales relacionados con la seguridad del enfermo en la actualidad. Así, se propone que este tema no sólo sea discutido en los consejos de ética del área de la salud, sino también en los comités interdisciplinarios de bioética clínica y asistencial, proporcionando un ejercicio más amplio y concreto de reflexión bioética.

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          Most cited references19

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          Transforming healthcare: a safety imperative.

          Ten years ago, the Institute of Medicine reported alarming data on the scope and impact of medical errors in the US and called for national efforts to address this problem. While efforts to improve patient safety have proliferated during the past decade, progress toward improvement has been frustratingly slow. Some of this lack of progress may be attributable to the persistence of a medical ethos, institutionalized in the hierarchical structure of academic medicine and healthcare organizations, that discourages teamwork and transparency and undermines the establishment of clear systems of accountability for safe care. The Lucian Leape Institute, established by the US National Patient Safety Foundation to provide vision and strategic direction for the patient safety work, has identified five concepts as fundamental to the endeavor of achieving meaningful improvement in healthcare system safety. These five concepts are transparency, care integration, patient/consumer engagement, restoration of joy and meaning in work, and medical education reform. This paper introduces the five concepts and illustrates the meaning and implications of each as a component of a vision for healthcare safety improvement. In future roundtable sessions, the Institute will further elaborate on the meaning of each concept, identify the challenges to implementation, and issue recommendations for policy makers, organizations, and healthcare professionals.
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            Patient safety in developing countries: retrospective estimation of scale and nature of harm to patients in hospital

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              Barriers to incident reporting in a healthcare system.

              Learning from mistakes is key to maintaining and improving the quality of care in the NHS. This study investigates the willingness of healthcare professionals to report the mistakes of others. The questionnaire used in this research included nine short scenarios describing either a violation of a protocol, compliance with a protocol, or improvisation (where no protocol exists). By developing different versions of the questionnaire, each scenario was presented with a good, poor, or bad outcome for the patient. The participants (n = 315) were doctors, nurses, and midwives from three English NHS trusts who volunteered to take part in the study and represented 53% of those originally contacted. Participants were asked to indicate how likely they were to report the incident described in each scenario to a senior member of staff. The findings of this study suggest that healthcare professionals, particularly doctors, are reluctant to report adverse events to a superior. The results show that healthcare professionals, as might be expected, are most likely to report an incident to a colleague when things go wrong (F(2,520) = 82.01, p < 0.001). The reporting of incidents to a senior member of staff is also more likely, irrespective of outcome for the patient, when the incident involves the violation of a protocol (F(2,520) = 198.77, p < 0.001. It appears that, although the reporting of an incident to a senior member of staff is generally not very likely, particularly among doctors, it is most likely when the incident represents the violation of a protocol with a bad outcome. An alternative means of organisational learning that relies on the identification of system (latent) failures before, rather than after, an adverse event is proposed.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                bioet
                Revista Bioética
                Rev. Bioét.
                Conselho Federal de Medicina (Brasília, DF, Brazil )
                1983-8042
                1983-8034
                September 2019
                : 27
                : 3
                : 401-409
                Affiliations
                [1] Brasília Distrito Federal orgnameUniversidade de Brasília orgdiv1Cátedra Unesco de Bioética orgdiv2Departamento de Ciências da Saúde Brazil telmarejane68@ 123456gmail.com
                Article
                S1983-80422019000300401
                10.1590/1983-80422019273323
                b5baed16-60f7-411a-a43c-71e64b43ca04

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 23 January 2018
                : 15 April 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 26, Pages: 9
                Product

                SciELO Brazil

                Categories
                Atualização

                Códigos de ética,Bioética,Segurança do paciente,Saúde pública,Bioethics,Codes of ethics,Patient safety,Public health,Seguridad del paciente,Salud pública

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