Indicadores clínicos e de qualidade de pacientes em hemodiálise

• Autor(a) principal: Silva, Simone Soares da
• Data de Publicação: 2018
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Federal do Espírito Santo (riUfes)
• Texto Completo: http://repositorio.ufes.br/handle/10/10828
• topic: Quality indicators in healthcare; Hospital hemodialysis units; Nursing; Indicadores de qualidade em assistência à saúde; Unidades hospitalares de hemodiálise; Enfermagem; Enfermagem; 61

Introduction: Quality care for the chronic renal patient is considered a challenge for both health professionals and government agencies. The major obstacle is the lack of standardization of practices and evaluation of service quality. In hemodialysis services, ensuring quality care is even more challenging, as it is an environment with a high degree of complexity, with different activities, requiring adequate physical space to offer treatment, in addition to the need for professionals with specific knowledge and skills. . However, there is still a lack of tools that help health service professionals, especially nurses, in organizing data to systematize care and care. This project is aligned with a line of research or treatment in nursing in the human development process and was developed motivated by institutional demand. Objective: To develop a software for registry, compiling, manage and reading of clinical and quality indicators of the hemodialysis service of a university hospital in the southeast region of Brazil, and describe this data, registered retrospective and manually by the nursing. Methods: This dissertation has two interdependent studies: a methodological study to build a software and a descriptive study with a quantitative approach to retrospective and secondary data collection. In the methodological study, the judges who participated in the validation process of the contents of the items that composed the software formed the population. In the descriptive study, clinical and quality indicators were collected from July 1, 2015 to June 30, 2016. Results: a product was developed:The software designed, was named Hemodialysis Support System (SAHD) and aims to record, compile, manage and read clinical and quality indicators registered during the hemodialysis process. It has 15 screens that include the registration and follow-up of the patients; it also allows the generation of data charts, so that it is possible to periodically created statistical data on the progression of the registered patients. With the descriptive study, it was observed the high prevalence of chronic kidney disease in men aged 18 to 69 years. Diabetic nephropathy was the most representative disease; the most implanted and infected catheter was a short-term central venous catheter, with Staphylococcus epidermidis being the most commonly found microorganism; vancomycin and gentamicin were the main antibiotics used. As for the adverse event, the most prevalent was extracorporeal system coagulation. SAHD is an unprecedented software for control to register and read clinical and quality indicators in hemodialysis. Conclusion: This research has the potential to generate impact and be applied at the local, regional and national level because it is a software, it is specific software for data control in hemodialysis. After the content validation process, it was possible to build a software that has the purpose of collecting clinical and quality indicators. With the description of the retrospective data, it was possible to perform the analysis of clinical indicators and quality of service. It is expected that the software designed will be able to optimize the work of the health team that provides assistance in the hemodialysis service and that the information generated serve as a basis for health care planning and for the implementation of actions focused on the main characteristics that interfere with the quality of healthcare. This study has potential for local applicability, but may be expanded to other hemodialysis clinics.