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Ferramenta de gestão na promoção da melhoria contínua da qualidade e segurança do utente a ser submetido a cirurgia eletiva: checklist DIIVA
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Advisor(s)
Abstract(s)
O presente relatório surge no âmbito do 2º Mestrado em Enfermagem Perioperatória
da Escola Superior de Saúde do Instituto Politécnico de Setúbal, sendo o Relatório de Estágio o
trabalho final de Mestrado. Ao longo do mesmo é realizada a análise e reflexão do percurso
percorrido com vista à aquisição de conhecimentos e competências de enfermeiro Mestre em
Enfermagem Perioperatória. Este relatório pretende apresentar o trabalho desenvolvido em
estágio em ambiente clínico perioperatório, centrado na identificação de um problema real,
apoiado pela metodologia de projeto.
Sendo a cultura de segurança no meio hospitalar um assunto emergente da atualidade,
esta surge também na identificação de áreas problemáticas no local de trabalho. Deteta-se o
adiamento ou cancelamento de cirurgias por falta de material, resultante da ausência de
ferramentas da gestão do mesmo. A lista de verificação da segurança cirúrgica da OMS, apesar
da sua extrema importância e utilidade, não prevê atempadamente a preparação de todos os
dispositivos, instrumentos e implantes que possam ser necessários à cirurgia.
Foi utilizado como referencial teórico, a Teoria das Transições de Afaf Meleis, uma
Teoria de Médio Alcance que, a nosso ver, está estreitamente relacionada com os utentes a
serem submetidos a cirurgia, e a sua relação com os enfermeiros perioperatórios. De forma a
fundamentar as temáticas abordadas ao longo do relatório, efetuou-se uma revisão integrativa
da literatura, realizando uma pesquisa alargada do fenómeno em estudo. A recolha de dados foi
efetuada em junho de 2018, com recurso a um questionário aplicado aos profissionais de saúde de um bloco operatório. Participaram 36 profissionais e a maioria identificou como
intercorrências no bloco operatório do último ano: cancelamento de cirurgias por falta de
material, falta de comunicação da equipa multidisciplinar, material fora do prazo de validade,
falta de instrumental cirúrgico e falha nos equipamentos.
Dada a identificação da problemática por parte dos profissionais, foi criada uma
ferramenta de apoio à gestão do material cirúrgico - Checklist DIIVA - que permite verificar a
disponibilidade dos dispositivos, implantes e instrumentos e respetivos prazos validade,
atempadamente, procurando dar resposta ao problema identificado e assegurar a melhoria
contínua dos cuidados de enfermagem perioperatórios.
This report is presented within the scope of the 2nd Masters in Perioperative Nursing taken in Escola Superior de Saúde do Instituto Politécnico de Setúbal. The Internship Report is the final master’s work. Throughout the same is carried out the analysis and reflection of the course viewing the acquisition of knowledge and skills of Master nurse in Perioperative Nursing. This report intends to present the work developed in a perioperative clinical stage, centered on the identification of a real problem, supported by the project methodology. Since safety culture in the hospital environment is an emerging issue, it also arises in the identification of problem areas in the workplace. Deferral is the postponement or cancellation of surgeries due to lack of material, resulting from the absence of management tools. The surgical safety checklist, despite its extreme importance and usefulness, does not provide timely preparation of all devices, instruments and implants that may be necessary for surgery. The Afaf Meleis Theory of Transitions was used as a theoretical reference. It´s a Medium Sized Theory that, in our opinion, is closely related to the patients to be submitted to surgery, and its relationship with the perioperative nurses. To substantiate the themes addressed throughout the report, an integrative review of the literature was carried out, executing a broad survey of the phenomenon under study. Data collection was performed in June 2018, using a questionnaire applied to health professionals from an operating room. 36 professionals participated and most identified as complications in the last year's operating room: surgery cancellation due to lack of material, lack of communication of the multidisciplinary team, material with expired date, lack of surgical instruments and equipment failure. Given the identification of the problem by the professionals, a tool was created to support the management of the surgical material - DIIVA checklist - which allows checking the availability of devices, implants and instruments and their validity, in a timely manner, to respond to the identified problem and continuous improvement of perioperative nursing care.
This report is presented within the scope of the 2nd Masters in Perioperative Nursing taken in Escola Superior de Saúde do Instituto Politécnico de Setúbal. The Internship Report is the final master’s work. Throughout the same is carried out the analysis and reflection of the course viewing the acquisition of knowledge and skills of Master nurse in Perioperative Nursing. This report intends to present the work developed in a perioperative clinical stage, centered on the identification of a real problem, supported by the project methodology. Since safety culture in the hospital environment is an emerging issue, it also arises in the identification of problem areas in the workplace. Deferral is the postponement or cancellation of surgeries due to lack of material, resulting from the absence of management tools. The surgical safety checklist, despite its extreme importance and usefulness, does not provide timely preparation of all devices, instruments and implants that may be necessary for surgery. The Afaf Meleis Theory of Transitions was used as a theoretical reference. It´s a Medium Sized Theory that, in our opinion, is closely related to the patients to be submitted to surgery, and its relationship with the perioperative nurses. To substantiate the themes addressed throughout the report, an integrative review of the literature was carried out, executing a broad survey of the phenomenon under study. Data collection was performed in June 2018, using a questionnaire applied to health professionals from an operating room. 36 professionals participated and most identified as complications in the last year's operating room: surgery cancellation due to lack of material, lack of communication of the multidisciplinary team, material with expired date, lack of surgical instruments and equipment failure. Given the identification of the problem by the professionals, a tool was created to support the management of the surgical material - DIIVA checklist - which allows checking the availability of devices, implants and instruments and their validity, in a timely manner, to respond to the identified problem and continuous improvement of perioperative nursing care.
Description
Relatório de Estágio do Mestrado em Enfermagem Perioperatória
Keywords
Segurança Qualidade Checklist Bloco Operatório Enfermagem perioperatória Safety Quality Operating room Perioperative nursing
Pedagogical Context
Citation
Publisher
Instituto Politécnico de Setúbal. Escola Superior de Saúde