Indicadores de processo para a prevenção da infecção do sítio cirúrgico em um hospital universitário do centro-oeste brasileiro
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFG |
Texto Completo: | http://repositorio.bc.ufg.br/tede/handle/tede/3329 |
Resumo: | INTRODUCTION: Evidence shows that out of every ten people in the world, one has been the victim of medical errors or preventable adverse events. These statistics are further evidence that of the 234 million patients undergoing surgeries, seven million suffer postoperative complications, increasing mortality rates by around 0.4 to 10%. A surgical site infection is considered the second highest incidence of major impact to the morbidity and mortality of patients, and may cause irreparable physical and emotional harm, as well as increase the cost of therapy for institutions. This reality drove the Safe Surgery Saves Lives program, which is the second Global Challenge for the World Alliance for Patient Safety program, launched by the World Health Organization in 2004. Studies organized by the National Health Surveillance Agency of Brazil, derived from these campaigns, cataloged nine process indicators to prevent these infections, which were the subject of this investigation. OBJECTIVE: To examine the process indicators for the prevention of surgical site infection in the perioperative period in patients undergoing clean surgery in a teaching hospital in central-western Brazil. METHODS: Retrospective analytical cohort study, conducted in 700 records of patients aged 18 years or older undergoing clean surgical procedures from January 2008 to December 2010. We used a structured form, previously evaluated according to national guidelines. Data were entered into SPSS version 15 for Windows. The analysis was descriptive and multivariate, and used chi-square tests, Fisher, and odds ratio (OR) as measures of association for variables with p <0.10. Statistically significant associations with p <0.05 were considered. RESULTS: Regarding the socio-demographic profile of the patients, 57.1% were female, aged between 18 and 101 years, 39.3% had comorbidities, 74.5% with ASA ≤ II. Regarding surgical specialty, 29.9% were orthopedic and 19.9% were vascular. Nonconforming indicators were found in 64.6%. Aspects such as the time of preoperative hospitalization, the method used for hair removal, the duration of antimicrobial prophylaxis, glycemic control in diabetics, as well as the thermal controls and inspection records of the surgical cases were not considered appropriate. The predictors for surgical site infection in the univariate analysis were male gender, carriers of chronic disease, alcoholism and smoking, infections already present on admission, a length of preoperative hospital stay of greater than 5 days, ASA ≥ III, shaving and antimicrobial prophylaxis; the independent factors were: being a carrier of a chronic disease, infections already present on admission and shaving with a razor blade. The estimated rate of infection was 10%. The surgical specialty with the highest rate of infection was vascular, with 25.9%. The methicillin-resistant Staphylococcus aureus was the most evident causative agent. CONCLUSION: We conclude that the service partially meets the process indicators for the prevention of surgical site infection in the perioperative period of clean surgeries, incongruent with the principles of the Safe Surgery Saves Lives program. |
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Palos, Marinésia Aparecida PradoBarreto, Regiane Aparecida dos santos SoaresPalos, Marinésia Aparecida PradoMrué, MruéBezerra, Ana Lúcia Queiroz BezerraBrandão, Marcelo LuizSousa, Adenícia Custódia Silva ehttp://lattes.cnpq.br/6381118150257039Gebrim, Cyanéa Ferreira Lima2014-10-10T20:22:27Z2013-03-26GEBRIM, Cyanéa Ferreira Lima. Indicadores de processo para a prevenção da infecção do sítio cirúrgico em um hospital universitário do centro-oeste brasileiro. 2013. 170 f. Dissertação (Mestrado em Enfermagem) - Universidade Federal de Goiás, Goiânia, 2013.http://repositorio.bc.ufg.br/tede/handle/tede/3329INTRODUCTION: Evidence shows that out of every ten people in the world, one has been the victim of medical errors or preventable adverse events. These statistics are further evidence that of the 234 million patients undergoing surgeries, seven million suffer postoperative complications, increasing mortality rates by around 0.4 to 10%. A surgical site infection is considered the second highest incidence of major impact to the morbidity and mortality of patients, and may cause irreparable physical and emotional harm, as well as increase the cost of therapy for institutions. This reality drove the Safe Surgery Saves Lives program, which is the second Global Challenge for the World Alliance for Patient Safety program, launched by the World Health Organization in 2004. Studies organized by the National Health Surveillance Agency of Brazil, derived from these campaigns, cataloged nine process indicators to prevent these infections, which were the subject of this investigation. OBJECTIVE: To examine the process indicators for the prevention of surgical site infection in the perioperative period in patients undergoing clean surgery in a teaching hospital in central-western Brazil. METHODS: Retrospective analytical cohort study, conducted in 700 records of patients aged 18 years or older undergoing clean surgical procedures from January 2008 to December 2010. We used a structured form, previously evaluated according to national guidelines. Data were entered into SPSS version 15 for Windows. The analysis was descriptive and multivariate, and used chi-square tests, Fisher, and odds ratio (OR) as measures of association for variables with p <0.10. Statistically significant associations with p <0.05 were considered. RESULTS: Regarding the socio-demographic profile of the patients, 57.1% were female, aged between 18 and 101 years, 39.3% had comorbidities, 74.5% with ASA ≤ II. Regarding surgical specialty, 29.9% were orthopedic and 19.9% were vascular. Nonconforming indicators were found in 64.6%. Aspects such as the time of preoperative hospitalization, the method used for hair removal, the duration of antimicrobial prophylaxis, glycemic control in diabetics, as well as the thermal controls and inspection records of the surgical cases were not considered appropriate. The predictors for surgical site infection in the univariate analysis were male gender, carriers of chronic disease, alcoholism and smoking, infections already present on admission, a length of preoperative hospital stay of greater than 5 days, ASA ≥ III, shaving and antimicrobial prophylaxis; the independent factors were: being a carrier of a chronic disease, infections already present on admission and shaving with a razor blade. The estimated rate of infection was 10%. The surgical specialty with the highest rate of infection was vascular, with 25.9%. The methicillin-resistant Staphylococcus aureus was the most evident causative agent. CONCLUSION: We conclude that the service partially meets the process indicators for the prevention of surgical site infection in the perioperative period of clean surgeries, incongruent with the principles of the Safe Surgery Saves Lives program.INTRODUÇÃO: Evidências apontam que, de cada dez pessoas no mundo, uma tem sido vítima de erros ou eventos adversos evitáveis. As estatísticas reforçam que, dos 234 milhões de pacientes submetidos a procedimentos cirúrgicos, sete milhões sofrem complicações pós-operatórias, elevando as taxas de mortalidade em torno de 0,4 a 10%. A infecção do sítio cirúrgico é considerada como o segundo incidente de maior impacto para a morbimortalidade dos pacientes, podendo gerar prejuízos físicos e emocionais irreparáveis, além de onerar os custos com a terapêutica para as instituições. Essa realidade impulsionou o programa Cirurgias Seguras Salvam Vidas, o qual representa o segundo Desafio Global da Aliança Mundial para a Segurança do Paciente, lançado pela Organização Mundial da Saúde, em 2004. Estudo organizado pela Agência Nacional de Vigilância Sanitária do Brasil, proveniente dessa campanha, catalogou nove indicadores de processo para prevenção dessas infecções, os quais foram objeto dessa investigação. OBJETIVO: analisar os indicadores de processo para a prevenção da infecção do sítio cirúrgico no perioperatório de pacientes submetidos à cirurgia limpa em um hospital universitário do Centro-Oeste brasileiro. MÉTODO: Estudo de coorte retrospectiva do tipo analítico, realizado por meio de 700 prontuários de pacientes, maiores ou igual a 18 anos, submetidos a procedimento cirúrgico limpo, de janeiro de 2008 a dezembro de 2010. Foi utilizado um formulário estruturado e previamente avaliado segundo as diretrizes nacionais. Os dados foram inseridos no Statistical Package For The Social Science versão 15 for Windows. A análise foi descritiva e multivariada, com testes qui-quadrado, Fisher e OR (odds ratio) como medidas de associação em variáveis com p<0,10. Foram consideradas estatisticamente significantes as associações com p<0,05. RESULTADOS: Quanto ao perfil sociodemográfico dos pacientes, 57,1% eram do sexo feminino, com idade entre 18 e 101 anos; 39,3% apresentavam comorbidades; 74,5%, com ASA ≤II. Quanto à especialidade cirúrgica, 29,9% ortopédica e 19,9% vascular. Inconformidades nos indicadores foram encontradas em 64,6%. Aspectos como o tempo de internação pré-operatória, o método usado para tricotomia, a duração da profilaxia antimicrobiana, o controle glicêmico em diabéticos, o controle térmico e o registro de inspeção das caixas cirúrgicas foram considerados não adequados. Os preditores para infecção do sítio cirúrgico pela análise univariada foram: sexo masculino, portador de doença crônica, etilismo e tabagismo, infecção à distância, tempo de internação pré-operatória > 5 dias, ASA ≥ III, tricotomia e a profilaxia antimicrobiana; os fatores independentes foram: ser portador de doença crônica, infecção à distância e tricotomia com lâmina de barbear. A taxa de infecção foi de 10%. A especialidade cirúrgica que apresentou maior índice de infecção foi a vascular, com 25,9%. O Staphylococcus aureus resistente à meticilina foi o agente etiológico de maior evidência. CONCLUSÃO: Concluiu-se que o serviço atende, parcialmente, os indicadores de processo para a prevenção da infecção do sítio cirúrgico no perioperatório de cirurgias limpas, em conformidade com os princípios do programa Cirurgias Seguras Salvam Vidas.Submitted by Marlene Santos (marlene.bc.ufg@gmail.com) on 2014-10-09T18:35:18Z No. of bitstreams: 2 Dissertação - Cyanéa Ferreira Lima Gebrim - 2013.pdf: 3845999 bytes, checksum: b72ce5420f222db9dbda99928197bd67 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5)Approved for entry into archive by Jaqueline Silva (jtas29@gmail.com) on 2014-10-10T20:22:27Z (GMT) No. of bitstreams: 2 Dissertação - Cyanéa Ferreira Lima Gebrim - 2013.pdf: 3845999 bytes, checksum: b72ce5420f222db9dbda99928197bd67 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5)Made available in DSpace on 2014-10-10T20:22:27Z (GMT). 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dc.title.por.fl_str_mv |
Indicadores de processo para a prevenção da infecção do sítio cirúrgico em um hospital universitário do centro-oeste brasileiro |
dc.title.alternative.eng.fl_str_mv |
Process indicators for the prevention of surgical site infections in a teaching hospital in central-western Brazil. |
title |
Indicadores de processo para a prevenção da infecção do sítio cirúrgico em um hospital universitário do centro-oeste brasileiro |
spellingShingle |
Indicadores de processo para a prevenção da infecção do sítio cirúrgico em um hospital universitário do centro-oeste brasileiro Gebrim, Cyanéa Ferreira Lima Indicadores de qualidade em qssistência à saúde (processos e resultados) Segurança do paciente cirurgia Infecção da ferida operatória Enfermagem perioperatória Quality indicators Health care Patient safety Surgery Surgical wound infection Perioperative nursing CIENCIAS DA SAUDE::ENFERMAGEM |
title_short |
Indicadores de processo para a prevenção da infecção do sítio cirúrgico em um hospital universitário do centro-oeste brasileiro |
title_full |
Indicadores de processo para a prevenção da infecção do sítio cirúrgico em um hospital universitário do centro-oeste brasileiro |
title_fullStr |
Indicadores de processo para a prevenção da infecção do sítio cirúrgico em um hospital universitário do centro-oeste brasileiro |
title_full_unstemmed |
Indicadores de processo para a prevenção da infecção do sítio cirúrgico em um hospital universitário do centro-oeste brasileiro |
title_sort |
Indicadores de processo para a prevenção da infecção do sítio cirúrgico em um hospital universitário do centro-oeste brasileiro |
author |
Gebrim, Cyanéa Ferreira Lima |
author_facet |
Gebrim, Cyanéa Ferreira Lima |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Palos, Marinésia Aparecida Prado |
dc.contributor.advisor-co1.fl_str_mv |
Barreto, Regiane Aparecida dos santos Soares |
dc.contributor.referee1.fl_str_mv |
Palos, Marinésia Aparecida Prado |
dc.contributor.referee2.fl_str_mv |
Mrué, Mrué |
dc.contributor.referee3.fl_str_mv |
Bezerra, Ana Lúcia Queiroz Bezerra |
dc.contributor.referee4.fl_str_mv |
Brandão, Marcelo Luiz |
dc.contributor.referee5.fl_str_mv |
Sousa, Adenícia Custódia Silva e |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/6381118150257039 |
dc.contributor.author.fl_str_mv |
Gebrim, Cyanéa Ferreira Lima |
contributor_str_mv |
Palos, Marinésia Aparecida Prado Barreto, Regiane Aparecida dos santos Soares Palos, Marinésia Aparecida Prado Mrué, Mrué Bezerra, Ana Lúcia Queiroz Bezerra Brandão, Marcelo Luiz Sousa, Adenícia Custódia Silva e |
dc.subject.por.fl_str_mv |
Indicadores de qualidade em qssistência à saúde (processos e resultados) Segurança do paciente cirurgia Infecção da ferida operatória Enfermagem perioperatória |
topic |
Indicadores de qualidade em qssistência à saúde (processos e resultados) Segurança do paciente cirurgia Infecção da ferida operatória Enfermagem perioperatória Quality indicators Health care Patient safety Surgery Surgical wound infection Perioperative nursing CIENCIAS DA SAUDE::ENFERMAGEM |
dc.subject.eng.fl_str_mv |
Quality indicators Health care Patient safety Surgery Surgical wound infection Perioperative nursing |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::ENFERMAGEM |
description |
INTRODUCTION: Evidence shows that out of every ten people in the world, one has been the victim of medical errors or preventable adverse events. These statistics are further evidence that of the 234 million patients undergoing surgeries, seven million suffer postoperative complications, increasing mortality rates by around 0.4 to 10%. A surgical site infection is considered the second highest incidence of major impact to the morbidity and mortality of patients, and may cause irreparable physical and emotional harm, as well as increase the cost of therapy for institutions. This reality drove the Safe Surgery Saves Lives program, which is the second Global Challenge for the World Alliance for Patient Safety program, launched by the World Health Organization in 2004. Studies organized by the National Health Surveillance Agency of Brazil, derived from these campaigns, cataloged nine process indicators to prevent these infections, which were the subject of this investigation. OBJECTIVE: To examine the process indicators for the prevention of surgical site infection in the perioperative period in patients undergoing clean surgery in a teaching hospital in central-western Brazil. METHODS: Retrospective analytical cohort study, conducted in 700 records of patients aged 18 years or older undergoing clean surgical procedures from January 2008 to December 2010. We used a structured form, previously evaluated according to national guidelines. Data were entered into SPSS version 15 for Windows. The analysis was descriptive and multivariate, and used chi-square tests, Fisher, and odds ratio (OR) as measures of association for variables with p <0.10. Statistically significant associations with p <0.05 were considered. RESULTS: Regarding the socio-demographic profile of the patients, 57.1% were female, aged between 18 and 101 years, 39.3% had comorbidities, 74.5% with ASA ≤ II. Regarding surgical specialty, 29.9% were orthopedic and 19.9% were vascular. Nonconforming indicators were found in 64.6%. Aspects such as the time of preoperative hospitalization, the method used for hair removal, the duration of antimicrobial prophylaxis, glycemic control in diabetics, as well as the thermal controls and inspection records of the surgical cases were not considered appropriate. The predictors for surgical site infection in the univariate analysis were male gender, carriers of chronic disease, alcoholism and smoking, infections already present on admission, a length of preoperative hospital stay of greater than 5 days, ASA ≥ III, shaving and antimicrobial prophylaxis; the independent factors were: being a carrier of a chronic disease, infections already present on admission and shaving with a razor blade. The estimated rate of infection was 10%. The surgical specialty with the highest rate of infection was vascular, with 25.9%. The methicillin-resistant Staphylococcus aureus was the most evident causative agent. CONCLUSION: We conclude that the service partially meets the process indicators for the prevention of surgical site infection in the perioperative period of clean surgeries, incongruent with the principles of the Safe Surgery Saves Lives program. |
publishDate |
2013 |
dc.date.issued.fl_str_mv |
2013-03-26 |
dc.date.accessioned.fl_str_mv |
2014-10-10T20:22:27Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
GEBRIM, Cyanéa Ferreira Lima. Indicadores de processo para a prevenção da infecção do sítio cirúrgico em um hospital universitário do centro-oeste brasileiro. 2013. 170 f. Dissertação (Mestrado em Enfermagem) - Universidade Federal de Goiás, Goiânia, 2013. |
dc.identifier.uri.fl_str_mv |
http://repositorio.bc.ufg.br/tede/handle/tede/3329 |
identifier_str_mv |
GEBRIM, Cyanéa Ferreira Lima. Indicadores de processo para a prevenção da infecção do sítio cirúrgico em um hospital universitário do centro-oeste brasileiro. 2013. 170 f. Dissertação (Mestrado em Enfermagem) - Universidade Federal de Goiás, Goiânia, 2013. |
url |
http://repositorio.bc.ufg.br/tede/handle/tede/3329 |
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por |
language |
por |
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4506162830365041981 |
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600 600 600 |
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2756753233336908714 |
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-7702826533010964327 |
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http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess |
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http://creativecommons.org/licenses/by-nc-nd/4.0/ |
eu_rights_str_mv |
openAccess |
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application/pdf |
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Universidade Federal de Goiás |
dc.publisher.program.fl_str_mv |
Programa de Pós-graduação em Enfermagem (FEN) |
dc.publisher.initials.fl_str_mv |
UFG |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
Faculdade de Enfermagem - FEN (RG) |
publisher.none.fl_str_mv |
Universidade Federal de Goiás |
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Universidade Federal de Goiás (UFG) |
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UFG |
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UFG |
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Repositório Institucional da UFG |
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Repositório Institucional da UFG |
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