Banca de DEFESA: FABRICIA CAVALCANTE ROCHA

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : FABRICIA CAVALCANTE ROCHA
DATE: 05/03/2021
TIME: 10:00
LOCAL: Universidade Federal do Rio Grande do Norte
TITLE:

IMPROVING QUALITY IN PLANNING SURGICAL-ORTHOPEDIC ASSISTANCE

KEY WORDS:

Surgery Department, Hospital; Quality Management; Orthopedics; Patient Care Planning; Quality Indicators, Health Care.

PAGES: 89
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUBÁREA: Saúde Pública
SUMMARY:

Introduction: The surgical-orthopedic care planning process starts with the indication of the procedure according to the patient’s need, goes through preoperative care for the surgery performance in the operating room, and ends with postoperative care and guidelines for discharge. Surgical assistance in the three moments (pre-, intra-, and postoperative) is a peculiar dynamic, as it involves several actors and technologies of varying complexity that must be synchronized to achieve a final objective: a surgery performed in a timely manner and without any harm to the patient at any stage of the surgical care process. Objective: This study aimed to evaluate the improvement in the care planning for patients undergoing elective orthopedic surgery in a public trauma reference hospital. Method: It was a quasi-experimental study of before-and-after design, without a control group, and quantitative approach, using a quality improvement cycle with problem analysis, intervention, and monitoring. Twenty criteria were developed to evaluate the quality of surgical care planning, based on causes classified as modifiable, observing the precepts of face validity, such as logical or apparent relevance, of content related to the dimension of quality, professionals’ needs and expectations, and of criteria, using scientific evidence. The study was conducted from January 2019 to December 2020. Data resulting from the intervention were submitted to descriptive and inferential statistical analysis and presented in a Pareto chart to highlight the level of improvement and its significance. The study followed the ethical procedures required by Resolutions no. 510/2016 and no. 580/2018 and was approved by the Research Ethics Committee of the Onofre Lopes University Hospital. Results: Results of this study refer to the compliance or non-compliance to the quality criteria listed and analyzed after the intervention actions within the proposed improvement cycle. There was a global improvement in the criteria, in which 70% (14 of 20) of the analyzed criteria presented increasing levels of compliance. Criteria C1, C2, C7, C18, C19, and C20 stood out for a higher level of compliance in the second evaluation. Regarding statistical significance, there were significant improvements in ten of the twenty criteria, which showed improved level of quality. Criteria C1, C2, C3, C6, C7, C11, C15, C19, and C20 were statistically highly significant (<0.001), which indicated that the improvement was real and that the statistical analysis of improvement between the two evaluations have less than one in a thousand chance of being wrong. Criteria C4 and C5 did not have the level of compliance found in the first evaluation due to lack of registration in the data sources. Criterion C12 demonstrated decreasing quality according to the evaluation of the absolute improvement. Conclusion: It was observed that the intervention activities improved most of the evaluated criteria related to the surgical-orthopedic care planning process. The stages of the intervention cycle enabled the development of activities by the multiprofessional team capable of contributing to the improvement of assistance to orthopedic patients during the perioperative period.

BANKING MEMBERS:
Presidente - 784.321.701-00 - VIVIANE PEIXOTO DOS SANTOS PENNAFORT - EBSERH
Interno - 911.028.804-00 - WILTON RODRIGUES MEDEIROS - UFRN
Externo à Instituição - VICTORIANO SORIA ALEDO
Externa à Instituição - ADRIANA CATARINA DE SOUZA OLIVEIRA - UCAM