Utilização da Ferramenta de Avaliação de Risco na APS de Belo Horizonte

Abstract

Users who seek the Health Service must have their risk assessed in a timely manner, in order not to worsen their health status while waiting for care. For this evaluation there are objective tools, which use colors to define order of priorities. The objective of this study is to evaluate the use of the Risk Assessment tool of the most prevalent conditions in Primary Health Care in Belo Horizonte. This is qualitative descriptive research. Data collection was performed from records in electronic medical records regarding the frequency and prevalence of use of the risk assessment tool on spontaneous demand recorded in the 152 health centers in Belo Horizonte in 2021. Qualitative data were obtained in March 2022, in two regions, through interviews with 12 nurses. The regional health centers were statistically identified as those with the highest and lowest records of use of the tool and, consequently, their health centers. These data were compiled by the discourse analysis proposed by Bardin and analyzed in the light of the literature. The interviews were identified in three categories:1) Use of the protocol and its limitations; 2) Records in the system and the hindering factors; and 3) Adaptability of the tool to the profile of user demand. Another data evaluated was related to the number of trained nurses, doctors and dentists, which exceeded 90% of the total, from the nine health regions. The use of the tool in health centers ranged from 2% to 81%, considering the 152 health centers evaluated, but the average rate of use in Belo Horizonte was 9.36%. The results demonstrate that it is important to assess the risk, but the time of the team professional and the lack of specific flowcharts were impediments to its application. Problems related to the system, related to registration and online appointments are crucial to be solved. Assigning a nurse only for risk assessment, conducting training and conversation circles about the use of the tool can help in the applicability of the protocol. In the nurses' perception, it is important to stratify the risk in PHC to order the waiting list according to clinical priority. The difficulties highlighted were the structure of the institution and changes in work processes in the PHC; it was found that the tool works better in modeling by a “reference team” and that it increases safety for the professional and the user, especially when referring to other points in the network. Based on the results, a Technical Report was prepared with recommendations for optimizing the use of the tool in PHC, to be sent to the Municipal Health Department, as a subsidy for possible interventions