Construção de matriz teórica sobre erro no trabalho de técnicas (os) em enfermagem

Abstract

This is an explanatory study with a qualitative and documentary approach. Its general objective was to construct a theoretical matrix on errors in the work process of nursing technicians working in hospital settings. To achieve this, the study adopted the constructivist strand of Grounded Theory as its methodological framework and historical-dialectical materialism as its theoretical foundation. The corpus of analysis consisted of ethical-disciplinary proceedings (PEDs) processed by the Regional Nursing Councils of the states of Bahia (COREN-BA), Alagoas (COREN-AL), Sergipe (COREN-SE), and Rio Grande do Norte (COREN-RN). These proceedings served as the data source and were composed of legal documents structured with information about the studied phenomenon — errors in the work of nursing technicians — including the chronology, the context in which the error occurred, and the behavior and discourse of the actors involved (the worker responsible for the error, the victim or patient or family member who suffered the harm, the defense or prosecution witnesses, and the judges represented by the Regional Nursing Councils). Three PEDs were selected based on the study’s inclusion criteria. From these PEDs, 936 pages were extracted for coding, generating 721 preliminary codes. These were later regrouped into 453 codes and, after constant comparative analysis and the process of theoretical saturation, 240 preliminary codes gave theoretical meaning and properties to 12 subcategories, 4 categories, and one central category. The central phenomenon identified was: “Left to one’s own fate,” labeled as an in-vivo code, which highlighted that the interaction of elements related to work precariousness — such as lack of organization in the work process, organizational negligence, and fear-based management — are determining factors in the occurrence of errors by nursing technicians in hospital settings. The theoretical model makes it possible to demonstrate that errors in the work of nursing technicians result from the interaction of elements of work precariousness — disorganization of work processes, organizational negligence, and fear-based management. Thus, within the hospital environment, both workers and patients/users remain at risk of errors, in a continuous and dynamic movement where chance or luck plays a substantial role in protecting against care- related errors.