Centro cirúrgico: percepção da equipe de enfermagem / Systematization of nursing care at the surgical center: perception of the nursing team / Sistematización de la atención de enfermería en el centro quirúrgico: percepción del equipo de enfermería

Objetivo: avaliar a atuação e a percepção da equipe de enfermagem quanto a Sistematização da Assistência de Enfermagem no centro cirúrgico de um hospital. Método: estudo exploratório, descritivo, documental, de abordagem mista, desenvolvido de janeiro a abril de 2019, em duas fases: análise de prontuários e entrevista com 14 profissionais de enfermagem. O cenário foi um centro cirúrgico de um hospital público no nordeste brasileiro. Organização dos dados pela análise estatística descritiva e análise temática. Resultados: a avaliação dos prontuários apontou que os registros da anamnese e exame físico são frágeis e em algumas fases não há registros da fase pré-operatória e pós-operatória. Verificou-se que para os profissionais o papel da equipe é prestar um cuidado holístico ao paciente e a fase mais dificultosa é a pós-operatória. Conclusão: a falta do planejamento para a implantação, execução e entendimento atrapalham o processo e dificulta uma assistência de qualidade ao paciente

Objective: to evaluate the performance and perception of the nursing team regarding the systematization of nursing care in the operating room of a hospital. Method: exploratory, descriptive, documentary study, with a mixed approach, developed from January to April 2019, in two phases: analysis of medical records and interview with 14 nursing professionals. The setting was a surgical center in a public hospital in northeastern Brazil. Data organization by descriptive statistical analysis and thematic analysis. Results: the evaluation of the medical records showed that the records of anamnesis and physical examination are fragile and in some phases there are no records of the preoperative and postoperative phase. It was found that for the professionals the role of the team is to provide holistic care to the patient and the most difficult phase is the post-operative. Conclusion: the lack of planning for the implementation, execution and understanding hinder the process and hinder quality patient care

Objetivo: evaluar el desempeño y la percepción del equipo de enfermería con respecto a la sistematización de los cuidados de enfermería en el quirófano de un hospital. Método: estudio exploratorio, descriptivo, documental, con enfoque mixto, desarrollado de enero a abril de 2019, en dos fases: análisis de historias clínicas y entrevista con 14 profesionales de enfermería. El escenario era un centro quirúrgico en un hospital público en el noreste de Brasil. Organización de datos mediante análisis estadístico descriptivo y análisis temático. Resultados: la evaluación de los registros médicos mostró que los registros de anamnesis y examen físico son frágiles y en algunas fases no hay registros de la fase preoperatoria y postoperatoria. Se descubrió que para los profesionales, el papel del equipo es proporcionar atención integral al paciente y la fase más difícil es la postoperatoria. Conclusión: la falta de planificación para la implementación, ejecución y comprensión dificulta el proceso y dificulta la calidad de la atención al paciente

Ambulatory Surgical Centers: A Review of Complications and Adverse Events.

An increasing number of orthopaedic surgeries are performed at ambulatory surgical centers (ASCs), as is exemplified by the 272% population-adjusted increase in outpatient rotator cuff repairs from 1996 to 2006. Outpatient surgery is convenient for patients and cost effective for the healthcare system. The rate of complications and adverse events following orthopaedic surgeries at ASCs ranges from 0.05% to 20%. The most common complications are pain and nausea, followed by infection, impaired healing, and bleeding; these are affected by surgical and patient risk factors. The most important surgeon-controlled factors are surgical time, type of anesthesia, and site of surgery, whereas the key patient comorbidities are advanced age, female sex, diabetes mellitus, smoking status, and high body mass index. As the use of ASCs continues to rise, an understanding of risk factors and outcomes becomes increasingly important to guide indications for and management of orthopaedic surgery in the outpatient setting.

[The technologies of inpatient care substitution in surgery]. / Statsionarzameshchayushchie tekhnologii v khirurgii.

It was analyzed the introduction of inpatient care substitution technologies in multi-disciplinary Polyclinic OAO «Gazprom¼. Organizational principles of outpatient surgical interventions under general and combined anesthesia are represented. Also it was described surgical features to decrease incidence of intra- and postoperative complications. System of active postoperative management was presented to define early different features of disease. Also main directions of development of this technology were suggested.

Cost-effectiveness analysis of stocking dantrolene in ambulatory surgery centers for the treatment of malignant hyperthermia.

BACKGROUND: Malignant hyperthermia (MH) is a rare hypermetabolic syndrome of the skeletal muscle and a potentially fatal complication of general anesthesia. Dantrolene is currently the only specific treatment for MH. The Malignant Hyperthermia Association of the United States has issued guidelines recommending that 36 vials (20 mg per vial) of dantrolene remain in stock at every surgery center. However, the cost of stocking dantrolene in ambulatory surgery centers has been a concern. The purpose of this analysis is to assess the cost-effectiveness of stocking dantrolene in ambulatory surgery centers as recommended by the Malignant Hyperthermia Association of the United States. METHODS: A decision tree model was used to compare treatment with dantrolene to a supportive care-only strategy. Model assumptions include the incidence of MH, MH case fatality with dantrolene treatment and with supportive care-only. Sensitivity analyses were performed to assess the robustness of the estimated cost-effectiveness. RESULTS: The estimated annual number of MH events in ambulatory surgery centers in the United States was 47. The incremental effectiveness of dantrolene compared with supportive care was 33 more lives saved per year. The incremental cost-effectiveness ratio was $196,320 (in 2010 dollars) per life saved compared with a supportive care strategy. Sensitivity analysis showed that the results were robust for the plausible range of all variables and assumptions tested. CONCLUSION: The results of this analysis suggest that stocking dantrolene for the treatment of MH in ambulatory surgery centers as recommended by the Malignant Hyperthermia Association of the United States is cost-effective when compared with the estimated values of statistical life used by U.S. regulatory agencies.

Calidad de vida de los profesionales en un centro quirúrgico / Quality of life of professionals in a surgical center

Objetivo: Evaluar la calidad de vida (CDV) del equipo de salud que trabaja en un centro quirúrgico en un hospital general en la región noroeste de Rio Grande do Sul, y relacionarla con las variables demográficas. Método: Es cuantitativo, descriptivo, transversal. Para recolectar los datos se utilizó el WHOQOL - BREF y datos demográficos de 21 profesionales. Resultados: Participación de 21 profesionales, 52,4% especialistas, 57,1% son mujeres, el 85,7% casados, con hijos, el 57,1% de 30 a 50 años incompletos de edad, el 42,9% tenían 50 años o más, 66, 6% trabaja 15 o más años en la profesión, el 57,1% optó por el centro de la cirugía, el 71,4% sin exclusividad. En los cuatro dominios del WHOQOL-BREF, el promedio obtenido fue: el físico 77,21, el psíquico 72.03, Relaciones Sociales el 71.43 y Medio Ambiente, el 65,3. Conclusión: Entrevistados evaluan la calidad de vida como "buena" o "muy buena" y "satisfecho" con su salud, independientemente de la edad y el sexo(AU)

Objective: To assess the quality of life (QOL) of the health team that works in a surgical center in a general hospital in the northwestern region of Rio Grande do Sul, and relate it to demographic variables. Methods: It is a cross-sectional, descriptive and quantitative study. Data collected by questionnaire and the WHOQOL - BREF. Results: 21 professionals, 52.4% specialists, 57.1% are female, 85.7% married, with children, 57.1% with 30 to 50 years old incomplete, 42.9% were 50 years or more; 66,6% work 15 or more years in the profession, 57.1% opted for the surgery center, 71.4% non-exclusivity. In the four domains of WHOQOL-BREF, the average gained 77.21 Physical, the Psychic 72.03, 71.43 Social Relations and Environment, 65.3. Conclusion: researched assess quality of life as "good" or "very good" and "satisfied" with their health, regardless of age and sex(AU)

Overnight observation in stand-alone surgicenters: is the practice safe?

The safety of performing operations in surgery centers that require overnight stays has not been established. To determine whether this practice is safe we performed a retrospective chart review of all cases performed at Paces over a 12-year period. There were 12,072 total cases and 11,147 general anesthesia (GA) or monitored anesthesia care (MAC) cases. Four thousand eight hundred ten patients stayed overnight. The hospital admission rate for patients undergoing either GA or MAC was 0.12% and for local anesthesia it was 0%. Overnight stay patients had a rate of 0.15%, while same day discharge patients had a rate of 0.08%. Excluding local anesthesia cases, the rate increased to 0.10%. For the GA and MAC patients, there was no statistical difference in hospitalization rates between the same day and the overnight stay groups. All patients had good outcomes after hospitalization. Performing operations that require an overnight stay in a surgery center can be a safe practice.

Procedimiento de actuación con pacientes alérgicos al látex en el entorno hospitalario / Action procedure for allergic patients to latex in the hospital surroundings

En la actualidad, el número de personas que presentan una sensibilizaciónal látex ha aumentado considerablemente, favorecidopor el hecho del contacto casi continuado en nuestra vida cotidianaa productos que contienen gomas. El entorno hospitalario, enconcreto, es un ambiente cargado de material susceptible de desencadenaruna reacción en pacientes alérgicos al látex y es necesariodar una atención segura ante cualquier situación, por lo quesurge este procedimiento de actuación.La estructura del procedimiento se encuadra dentro de la sistemáticade elaboración de protocolos y procedimientos del HospitalVirxe da Xunqueira (A Coruña) y está aprobado por la Dirección yel Servicio de Mellora da Calidade de nuestro hospital. En la realizacióndel mismo se han encontrado algunos problemas, en especial,por la dificultad de conocer la composición exacta de muchosde los artículos necesarios para la atención del paciente

The quantity of people whom actually show sensitivity to latex exposurehad increased of considerable way. It´s favoured, in ourdaily life, by the fact of the almost continual touch with productsthat contains gum materials. The specific hospital setting is a loadedenvironment of all kind of equipment capable to cause a reactionin latex allergic patients. For this reason is necessary to give asecure care in view of this possibility. The last is the motive becauseis necessary to make this suitable action procedure.The “latex allergic patients” procedure structure to fit himself in thesystematic of protocols and procedures elaboration valid in the Virxeda Xunqueira Hospital. This procedure was approved by ManagementStaff and by the Improvement Quality Service of our hospital.Over the elaboration of this procedure we met with some problemsconcerning to the scanty bibliography about the latex matter and sowe had troubles to know the precise composition of several necessaryequipment used to give care to the patients

Gerenciamento de novas tecnologias em centro cirúrgico pelas enfermeiras nos hospitais de feira de Santana - Ba / Management of new technologies in a surgery center by nurses in hospitals located in Feira de Santana - BA / Administración de nuevas tecnologías en centro quirúrgico por las enfermeras en los hospitales de Feira de Santana-BA

Trata-se de estudo quantitativo exploratório descritivo sobre o nível de adequação ao domínio das novas tecnologias (NADNT) das enfermeiras no gerenciamento de centro cirúrgico em hospitais de Feira de Santana - BA - Brasil, 2002. Teve como objetivos: avaliar o NADNT das enfermeiras no gerenciamento de centro cirúrgico (CC); identificar e descrever os fatores que interferem neste nível, bem como propor ações para o desenvolvimento deste nível no gerenciamento de CC. Amostra constituída por 33 enfermeiras com experiência de CC. Utlizou-se questionário para a coleta de dados. Conclui-se que o NADNT foi insatisfatório por 54,5 por cento dos sujeitos do estudo. Comprovou-se estatisticamente que a capacidade do hospital e a carga horária são fatores que interferem no domínio das novas tecnologias em CC.

It is a quantitative, exploratory, descriptive study about the level of adequacy of the command of new technologies (NADNT) by nurses in the management of a surgery center in hospitals located in Feira de Santana-BA, Brazil, in 2002. It aimed at: assessing the NADNT of nurses in the management of a surgery center; identifying and describing the factors that interfere with this level; and proposing actions for the development of this level in the management of surgery centers. Sample made up of 33 nurses with experience in surgery centers. A questionnaire was used for data collection. It has been concluded that the NADNT was unsatisfactory for 54.5 percent of the study subjects. It has been statistically proved that the capacity of the hospital and the working load are factors that interfere with the command of new technologies in surgery centers.

Se trata de un estudio cuantitativo explorador descriptivo sobre el nivel de adaptación del dominio de las nuevas tecnologías (nadnt) de las enfermeras en la administración del centro quirúrgico en hospitales de Feira de Santana - BA - Brasil, 2002. Tuvo como objetivos: evaluar el nadnt de las enfermeras y la administración del centro quirúrgico (cc) en los hospitales investigados, identificar y describir los factores que interfieren en este nivel, así como proponer acciones para el desarrollo de este nivel en la administración del (cc). La muestra se constituyó de 33 enfermeras con experiencia en (cc). Se utilizó cuestionario para la información de datos. Conclusiones: el dominio das las nuevas tecnologías fue considerado insatisfactorio por 54,5 por ciento de los sujetos del estudio. Estadísticamente, se comprobó que la capacidad del hospital y la carga horaria son factores que interfieren en el dominio de las nuevas tecnologías en cc.

[Management of new technologies in a surgery center by nurses in hospitals located in Feira de Santana - BA]. / Gerenciamento de novas tecnologias em centro cirúrgico pelas enfermeiras nos hospitais de Feira de Santana- Ba.

It is a quantitative, exploratory, descriptive study about the level of adequacy of the command of new technologies (NADNT) by nurses in the management of a surgery center in hospitals located in Feira de Santana-BA, Brazil, in 2002. It aimed at: assessing the NADNT of nurses in the management of a surgery center; identifying and describing the factors that interfere with this level; and proposing actions for the development of this level in the management of surgery centers. Sample made up of 33 nurses with experience in surgery centers. A questionnaire was used for data collection. It has been concluded that the NADNT was unsatisfactory for 54.5% of the study subjects. It has been statistically proved that the capacity of the hospital and the working load are factors that interfere with the command of new technologies in surgery centers.

Factores que inciden en la aplicación de los principios de asepsia y antisepsia en centro obstétrico y centro quirúrgico del hospital Gíneco - Obstétrico Isidro Ayora / Factors that affect the application of the principles of asepsis and antisepsis in obstetrical center and surgical center of the Gíneco hospital - Obstetrician Isidro Ayora

Nuestra investigación se basará en la búsqueda de los factores determinantes de este problema, a través de la revisión bibliográfica, observación directa y entrevistas. Se ha destacado que no se cumplen con los principios de asepsia y antisepsia debido a un alto grado de desmotivación especialmente del personal Auxiliar de Enfermería y de Limpieza, la infraestructura inadecuada, falta de educación contínua a todo el personal, ausencia de un programa de orientación al personal nuevo...