Banca de QUALIFICAÇÃO: PEDRO BRAGA LINHARES GARCIA

Uma banca de QUALIFICAÇÃO de MESTRADO foi cadastrada pelo programa.
STUDENT : PEDRO BRAGA LINHARES GARCIA
DATE: 19/10/2021
TIME: 10:00
LOCAL: Sala Virtual (google meet)
TITLE:

EVALUATION OF THE IMPLEMENTATION OF THE SAFE SURGERY PROTOCOL IN THE CARE LINE OF PATIENTS WITH FEMUR FRACTURES BEFORE AND AFTER THE QUALITY IMPROVEMENT CYCLE

KEY WORDS:

Hip fractures; total quality management; cirurgical

PAGES: 22
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUBÁREA: Saúde Pública
SUMMARY:

ntroduction/Justification: In 2007-2008, the member countries of the World Health Organization established the global challenge entitled “Safe Surgery Saves Lives'' and, in 2018, the Ministry of Health approved the Brazilian Guidelines for the Treatment of Neck Fractures of the Femur in the Elderly. It is known that investment in training and qualification of the surgical team is capable of improving safety indicators and increasing the safety of procedures. Objectives: This study aimed to assess the quality level of the implementation of the protocol for safe surgery for femoral fractures, in a reference hospital, before and after an improvement cycle. Materials and Methods: The study was carried out at the Hospital Regional do Sertão Central - HRSC, located in Quixeramobim-CE. This is an observational study to assess the implementation of a safe femoral fracture surgery protocol, before and after an improvement cycle, identifying procedural failures and the effects of the intervention. The femur fracture patient care line was implemented in 2019 at the HRSC and the safe surgery protocol improvement cycle for these patients was carried out in 2020. All patients admitted and operated on the femur fracture patient care line in year 2020 of the HRSC were evaluated for compliance with the protocols. Reoperations and those procedures without surgical incision were excluded. Data were collected by consulting the safety management worksheets, the line of care worksheet for patients with femoral fractures, the surgical safety checklist (“checklist”) and the medical record. The patients' sociodemographic information was collected from the medical records, in addition to the following parameters: surgical site infection rate; hospital readmission rate, reoperation rate and mortality rate in the first 90 days after admission; surgical outcome, length of hospital stay, time between fracture and hospital admission to the HRSC; time between admission and surgery; and compliance with the safe surgery protocol and the perioperative optimization protocol. Results: It was observed that most patients are female (65.8%), with a mean age of 73.5±16.5 years, with no statistical difference between the groups before and after the improvement cycle. As for the clinical outcomes, it was observed that, after the cycle of improvement, there was a slight decrease in the number of occurrences of the following adverse events: surgical site infection (p = 0.49), hospital readmission (p = 0.29), reoperation (p=0.19) and postoperative death (p=0.52), but this decrease was not statistically significant between the groups. The main procedural flaw identified was related to antibiotic prophylaxis, with representation around 80% in the Pareto analysis. Compliance with the safe surgery protocol rose from 28.7% before the improvement cycle to 48.4% after the improvement cycle, with this difference being statistically significant (p<0.001).
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BANKING MEMBERS:
Presidente - 1195933 - ANA CAROLINA PATRICIO DE ALBUQUERQUE SOUSA
Interna - 2330137 - VILANI MEDEIROS DE ARAUJO NUNES
Interno - 911.028.804-00 - WILTON RODRIGUES MEDEIROS - UFRN
Interno - 1868020 - ZENEWTON ANDRÉ DA SILVA GAMA