Registro eletrônico para a continuidade do cuidado ao paciente : um caso de uso para a passagem de plantão

Abstract

Background: The importance of effective communication for patient safety is critical when it comes to the practice of Doctor's handovers. Effective handovers are vital to patient safety and continuity of care, and this is Electronic handover provides better continuity of care than paper-based handover, and redistribution of tasks during working hours would benefit night staff. Objective: To present the protocol used for the analysis of the quality of information registered in the medical document used in the transference of care sessions between doctors shifts. Methods: This study is a clinical trial, controlled before-and-after in which observations were made before and after the implementation of an intervention, both in a group that receives the intervention. Handover session of physicians in the MATERNITY OF Hospital das Clínicas of the Universidade Federal de Minas Gerais, Brazil, randomly selected for monitoring. Eighteen before intervention and 18 after the intervention. Results: It is expected with the application of the protocols and the progress of the research that we can evaluate and infer about the use of a computerized tool to carry out the shift, improve the quality of information, length of the transfer, traceability, and audit, and especially safety and quality in patient care.