PATIENT SAFETY IN A PEDIATRIC INTENSIVE CARE UNIT IN THE MANAGEMENT OF RESPIRATORY DISEASES IN CHILDREN AND ADOLESCENTS: CHALLENGES FOR HEALTH MANAGEMENT AND QUALITY OF CARE

Abstract

Objective: To analyze the challenges faced by health management and the care team in promoting patient safety in the Pediatric Intensive Care Unit (PICU), focusing on risk mitigation and the quality of respiratory care in children and adolescents. Methods: Integrative literature review conducted in PubMed, SciELO, and VHL databases, covering the period from 2019 to 2026. Thirty-nine scientific articles with DOI were selected and analyzed under a multidimensional perspective that integrated strategic management and clinical practice. Results: Findings indicate that failures in ventilator configuration and ineffective communication during shift changes are critical vulnerabilities. The implementation of prevention bundles reduced ventilator-associated pneumonia (VAP) by 30%, although the sustainability of these measures depends on adequate staffing. The use of realistic simulation and tools such as SBAR demonstrated effectiveness in reducing adverse events. Conclusion: Patient safety in respiratory management in the PICU requires a systemic culture supported by monitoring technologies and clinical governance. It is concluded that care excellence depends on the alignment between operational management efficiency and family-centered humanized care.