Buenas prácticas para seguridad del paciente en centro quirúrgico: recomendaciones de enfermeros

Gutierres, Larissa de Siqueira; Santos, José Luís Guedes dos; Peiter, Caroline Cechinel; Menegon, Fernando Henrique Antunes; Sebold, Luciara Fabiane; Erdmann, Alacoque Lorenzini

doi:10.1590/0034-7167-2018-0449

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Brasil

Revista Brasileira de Enfermagem

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Sumário

RESEARCH • Rev. Bras. Enferm. 71 (suppl 6) • 2018 • https://doi.org/10.1590/0034-7167-2018-0449 copiar

Buenas prácticas para seguridad del paciente en centro quirúrgico: recomendaciones de enfermeros

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

Describir las recomendaciones de enfermeros para buenas prácticas de seguridad del paciente en el centro quirúrgico.

Método:

La investigación cuantitativa, del tipo descriptivo y exploratorio, desarrollada a partir de un survey on-line con 220 enfermeros de centro quirúrgico de diferentes regiones de Brasil. El procesamiento de los datos para el análisis textual fue realizado por el software IRAMUTEQ.

Resultados:

Se obtuvieron ocho recomendaciones: (1) La participación de un equipo multidisciplinario y los gestores de las instituciones; (2) Establecimiento de una cultura de seguridad del paciente; (3) Uso del checklist de cirugía segura; (4) Mejora de la comunicación interpersonal; (5) Ampliación de la actuación del enfermero; (6) Disponibilidad adecuada de recursos físicos, materiales y humanos; (7) Búsqueda individual por actualización profesional; y (8) Desarrollo de acciones de educación continuada.

Conclusión:

Estas recomendaciones pueden ser utilizadas como estrategias de gestión de cuidado por los enfermeros para la seguridad del paciente en centro quirúrgico.

Descriptores:
Seguridad del Paciente; Centros Quirúrgicos; Enfermería de Quirófano; Calidad de la Atención de Salud; Gestión de la Práctica Profesional

Recommendation	Qualitative synthesis
1. Involvement of the multiprofessional team and the managers of the institution	The search for patient safety in the operating room requires the involvement and participation of the multiprofessional team, especially surgeons and anesthetists, and the institution's managers. Nursing stands out in the development of actions aimed at patient safety, but this initiative can not only start from a professional category.
2. Establishment of a patient safety culture	The safety culture is a set of practices shared by the health team and planned institutionally to avoid risks to patients during the pre, intra and postoperative period. The planning of care should follow the institution's standard, but allow for adaptations according to the particularities of each patient and sector.
3. Use of the safe surgery checklist	The full application of the safe surgery checklist is critical to reducing damage to the surgical patient. Institutional protocols with adaptations of the safe surgery checklist to the specificities of the institution's care practice are recommended. It is important that the use of the checklist and safe surgical protocols is constantly monitored through a continuous improvement plan.
4. Improvement of interpersonal communication	Effective communication facilitates the standardization and continuity of care behaviors. It also contributes to the union and the good interpersonal relationship between the professionals of the health team, which makes possible the creation of a work environment favorable to the development of actions for patient safety. It is important to improve communication between the nursing staff, medical surgeons and anesthesiologists.
5. Expansion of nurses' performance	The expansion of nurses' work involves quantitative and qualitative aspects. Quantitatively, it is important to increase the number of nurses in the operating room, allowing them to stay longer in the operating room. Qualitatively, it is necessary to grant greater autonomy to the nurse in supervising the nursing staff in the operating room and conducting pre-operative nursing appointment.
6. Adequate availability of physical, material and human resources	The equipment and materials needed for the surgical procedure must be available in sufficient quantity and properly tested and/or checked before surgery. A preventive and periodic maintenance plan is essential for the proper functioning of equipment and materials. The work team must also be adequately sized and qualified to perform the actions that fit in the surgical context.
7. Individual search for professional updating	Health professionals should constantly seek the technical-scientific update to provide quality care to the surgical patient.
8. Development of continuing education actions	Continuing education should be systematic, involve professionals from all areas of care, and focus on updates on care procedures and new equipment and/or technologies available for patient safety. The success of continuing education actions is directly related to participation, and to the support of the institution's managers and leaders.

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

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[1] CORRESPONDING AUTHOR José Luís Guedes dos Santos E-mail: joseenfermagem@gmail.com