Comunicação efetiva entre a equipe de enfermagem e a segurança do paciente na maternidade: revisão integrativa

Abstract

Introduction: Inadequate communication in the care process can result in harm to the patient and the occurrence of adverse events in health services, such as in the maternity ward, where patient safety is focused on two or more people, in cases of multiple pregnancies. Objective: to analyze the evidence available in the scientific literature on the relationship between effective communication between the maternity nursing team and patient safety. Method: integrative review, guided by the question: how does effective communication by the maternity nursing team contribute to patient safety? We searched for primary studies in national and international databases, in which articles published in English, Portuguese and Spanish, in any period of time, that answered the research question were selected. After screening the retrieved articles, with subsequent data extraction in the included studies, a script prepared for this purpose was used. A critical evaluation of the selected studies was carried out using instruments for evaluating the levels of evidence and methodological quality for the synthesis and presentation of results. Results: 703 publications were retrieved; 444 were excluded due to duplication in reference managers; 234 were excluded because they did not meet the inclusion criteria by reading the title and abstract. 25 articles were selected to be read in full, 12 of which were excluded because they did not meet the inclusion criteria. Two studies were added from the references of the included studies, totaling 15 articles. Of these, nine (60%) are quantitative and six (40%) are qualitative. Regarding the place of publication, the United States of America is the country with the highest number of publications, 73.33% (n=11), followed by Australia, Italy, the Netherlands and South Africa with 6.66% (n= 1) each one. Highlighting the main results, a summary table of the sample publications was created and two categories were defined. The first is the use of communication facilitating resources, consisting of ten studies, highlighting the predominance of the use of instruments based on the mnemonic SBAR (Situation, background, assessment, recommendation), adapted in various ways depending on the time, structural and technological conditions . The second category was verbal communication: strengths and weaknesses, with five studies which indicate that verbal communication is weakened by rigid hierarchies, disputes in the multidisciplinary team and multiple care providers and enhanced by the linking of communication as an indicator of institutional quality. Conclusion: Through the selected evidence, it was considered that the use of facilitating tools allows communication in an orderly manner, the continuity of safe assistance to the mother and child binomial in the maternity environment and that verbal communication, despite being the preferred way easier to disseminate information, when used incorrectly, it harms the quality of care and, consequently, favors the emergence of adverse events, putting patient safety at risk. Therefore, this review brings together available evidence regarding effective communication during labor, delivery and the postpartum period, in addition to which communication is a fundamental strategy for increasing the quality of the service provided in maternal and child care units.