Organização dos prontuários dos pacientes na Unidade de Saúde João Paulo II

Abstract

The records are endorsed as informational repositories of fundamental importance in health care of the population, are important bases of information on certain pathology, its history, development, prescriptions, healing or palliative measures, and other related aspects (LUNARDELLI; TONELLO; MOLINA, 2014, p.115). Despite the above, it notes that the treatment of these documents is still far from ideal and the Basic Health Unit John Paul II does not refute this fact. At the unit in focus, the rampant increase in the number of calls has been providing accumulation of records, and these stored improperly, causing many problems for the service. It is intended to design, organize records in the Basic Health Unit John Paul II, adopting a strategy of training of archive professionals and reception archivists techniques and consistent legislation to these documents, as well as the implementation of a spreadsheet, with purpose of identifying the records dynamically, thus avoiding the opening of new records to users already registered. To support the plan were carried out research in the ScientificElectronic Library Online database (SciELO), Google Scholar with the descriptors: medical records, in-service training, file. Documents of Maceió Health Municipal and John Paul II Health Unit also subsidized the work.