Concepções e práticas dos profissionais do consultório na rua acerca do cuidado seguro

Abstract

This research has as object of study the conceptions and practices of the professionals of the Street Clinic regarding safe care and the guiding question that led to it was “What are the conceptions and practices of the professionals of the Street Clinic regarding safe care?”. Safe care can be understood as a structure of activities that create cultures, behaviors, processes, technologies and environments in health that consistently and sustainably mitigate risk, provide evidence of preventable harm, make errors less likely and decrease the impact of damage when it occurs. The objective was to understand the conceptions and practices of the professionals of the Street Office regarding safe care. This is a qualitative, comprehensive, exploratory and descriptive research. The study scenario was the capital of Alagoas. Twenty-one professionals from the Street Office participated in this research. The production of information took place through participant observation and focus group techniques. The treatment and interpretation of the information were combined, guided by the thematic analysis method proposed by Minayo. The study was submitted to the Research Ethics Committee of the Federal University of Alagoas and approved under opinion number 5,501,153. The results were organized and systematized into three thematic categories, namely: Conceptions and practices regarding safe care; Challenges faced for safe care in the street context; and, Strategies used for safe care. Participants, for the most part, expressed conceptions and practices about safe care related to the use of technologies at levels of care such as bonding, welcoming and empathy. They said that care safety is associated not only with performing procedures, but also considered the professional's own safety as part of the user's safety. Conceptions about safe care related to care that minimizes risks, as well as avoiding errors and damage, were evidenced. Difficulties associated with the lack of experience and professional qualification to work with homeless people were listed, as well as challenges related to the singularities found in the context of the street. In addition, the participants pointed out problems in the articulation and reception of users by other services that provide attention and care to the homeless population. Finally, the users' difficulties related to self-care, as well as the use of substances and the constant changes of territory were punctuated as challenges. Action planning was the main strategy revealed in the professionals' speeches. There were listed activities entitled pre-field, post-field, weekly team meeting and weekly schedule of activities. Sharing care and tasks, as well as communication between professionals, were also mentioned. Carrying out this study made it possible to understand the topic of safe care from the perspective of professionals at the Street Office. It is suggested the implementation of important actions to improve and qualify safe care for homeless people and, consequently, reduce the occurrence of incidents. The implications for practice can be perceived in the sense of strengthening awareness of the issue of safe care in Primary Care on the part of health professionals, users, managers, policy makers, educators and researchers. Encouraging safety among these subjects will be a potentiating factor for strategies aimed at improving quality and reducing incidents.