Implantação do consultório de enfermagem para seguimento ambulatorial de pacientes em pós-operatório de doença arterial obstrutiva periférica

• Autor(a) principal: Gebrim, Cyanéa Ferreira Lima
• Data de Publicação: 2017
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da UFG
• Texto Completo: http://repositorio.bc.ufg.br/tede/handle/tede/7982
• topic: Enfermagem perioperatória; Doença arterial periférica; Satisfação do paciente; Indicadores de qualidade em assistência à saúde; Perioperative nursing; Peripheral arterial disease; Patient satisfaction; Quality indicators; Health care; CIENCIAS DA SAUDE::ENFERMAGEM

AIM: to analyse the process of the implementation of nursing office for output follow-up of postoperative patientes of peripheral obstructive arterial disease, according to the structure, process and outcome indicators. METHOD: an uncontrolled, prospective intervention study conducted from 2013 to 2016 at the outpatient clinic of a university hospital in the Brazilian Midwest. Patients admitted to the nursing office for ambulatory follow-up in the postoperative period of peripheral obstructive arterial disease participated in the study. Two instruments were used to collect the data, the first to verify the sociodemographic profile and the second to measure the Patient Satisfaction index with the quality of nursing care. For statistical analysis, we used: absolute frequencies, median, mean and standard deviation, Raw Scale with logistic binary regression, Pearson correlation coefficient. RESULTS: the structure comprised: situational diagnosis, partnerships, training of the executing team and acquisition of physical and material resources. In the process, the methodology used for the care was the systematization of nursing care and as an outcome of the implementation of nursing office, the level of satisfaction of the patients with the nursing care was evaluated. A total of 39 patients, 51,3% male, mean age 63 years, 71.8% retired, 66.7% diabetic, 84.6% hypertensive, 71.8% dyslipidemic, 51.3% smoker, 84.9% sedentary. A total of 303 nursing consultations were performed, of which 80% of the patients evaluated were discharged and 15% needed rehospitalization. Nursing care reached an index of positivity (>80%) considered safe and of quality, and a high level of the patient satisfaction (mean: 4,195 and median 4). Five postoperative complications emerged: 53,9% surgical site infection, 10,3% amputations, 7,7% pain, 2,6% sepsis and 2,6% deaths. Statistically (p<0,05) more satisfied patients with nursing care were those that presented normal nutritional status (p=0,049), who assessed their health as poor or normal (p=0,020) and did not use anti-hypertensives (p=0,031). The Pearson Coefficients showed significant correlation, with an increasing association (r>0,0) between the technical-professional, educational and nurse's confidence domains. CONCLUSION: the structure of the nursing office, signaled important indicators in relation to the nursing practice, as a systematized service model for the follow-up of patients in the postoperative period of peripheral obstructive arterial disease, positively reflecting the improvement of the patients’ health. It emphasizes the early identification of some complications and the promotion of the quality of care with the lesion, in addition to narrowing the bond between the team and the patient. It impacted on the level of patient satisfation regarding the assistance provided by the nursing office team, in the outpatient follow-up of patients in the postoperative period of peripheral obstructive arterial disease.