Indicadores de qualidade em Centro Cirúrgico especializado em dermatologia: da implantação à análise
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Data
2016-12-15
Autores
Amaral, Juliana Aparecida Baldo [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Introdução: a preocupação com a qualidade nas organizações de saúde tem se manifestado por meio da busca de melhores práticas para atender tanto o mercado competitivo, como os seus clientes. Portanto, torna-se necessário e urgente dispor de informações relevantes para planejar, desenvolver e avaliar as ações de modo a instrumentalizar os gestores para avaliarem seus processos com racionalidade e criticidade. A utilização de indicadores é uma forma adequada de mensurar, comparar e agregar o juízo de valor ante o encontrado e o ideal estabelecido. Para tanto, necessitam ter sua coleta e sistematização bem planejadas, como forma de facilitar o desempenho das atividades para melhoria dos processos de trabalho. O Centro Cirúrgico é considerado uma das unidades mais complexas e específicas do hospital, cujo desempenho está diretamente relacionado com a qualidade de seus próprios processos e com os processos dos serviços que o apoiam. Objetivo: implantar e analisar indicadores de qualidade no Centro Cirúrgico de um hospital especializado em dermatologia. Método: estudo descritivo, analítico, prospectivo e transversal com abordagem quantitativa. O cenário da pesquisa foi um hospital público, especializado em dermatologia, no interior do Estado de São Paulo. A primeira etapa do estudo foi a busca de indicadores adequados para uso no Centro Cirúrgico de acordo com as características do hospital estudado e segundo a literatura existente nessa área. A segunda etapa consistiu na construção do instrumento para coletar os indicadores selecionados. A terceira etapa foi a implementação dos indicadores por meio de um processo educativo que avaliou o conhecimento prévio e posterior à realização do treinamento e a quarta etapa consistiu no levantamento e análise dos indicadores selecionados e implementados por essa pesquisa. Resultados: a busca na literatura, somada à necessidade da instituição, nortearam a seleção dos indicadores e a elaboração de instrumento estruturado para coleta de dados. Para implantação, realizou-se treinamento com 18 colaboradores, sendo possível inferir maior conhecimento sobre o assunto, após o processo educativo. Foram selecionados, deacordo com a significância e para análise, os indicadores: taxa de cirurgias suspensas, taxa de infecção em sítio cirúrgico em cirurgias limpas, taxa de acidentes de trabalho com profissionais de enfermagem, taxa de registros de enfermagem incompletos no período perioperatório, taxa de absenteísmo de enfermagem e taxa de ocupação (tempo total da Sala Operatória utilizada). Além dos indicadores, delineou-se o perfil dos pacientes e atendimentos do Centro Cirúrgico, de modo a conhecer o perfil institucional. Produto: a construção do instrumento para coletar os indicadores selecionados na literatura e adequados ao Centro Cirúrgico, bem como a implementação desses indicadores por meio de um processo educativo à equipe de enfermagem, constituíram-se nos produtos resultantes dessa pesquisa. Conclusões: a seleção dos indicadores de qualidade em Centro Cirúrgico propostos na literatura e adequados às características do hospital permitiu a construção de instrumento estruturado prático e apropriado à rotina local, contemplando aqueles referentes aos processos assistenciais e aos de gestão. O processo educativo junto à equipe atuante foi o que viabilizou essa implantação. A análise dos indicadores após um ano de coleta de dados, evidenciou características dos processos até então desconhecidas pelos membros da equipe, sendo possível atuar diretamente nas principais necessidades da unidade, proporcionando padronização e melhorias ao Centro Cirúrgico.
Introduction: the preoccupation with the quality in health organizations has been manifested through the search for better practices to meet not only the competitive market but also its customers. Therefore, it is fundamental and immediate to gather relevant pieces of information to plan, develop and evaluate the practices that are proposed and provide managers with instruments to evaluate their processes rationally and critically. The use of indicators is an applicable way to measure, compare and provide value face what is found and the established ideal. For this purpose, the collection and systematization need to be well planned in a way to facilitate the development of activities in order to improve the processes of work. The Operating Room is considered one of the most complex and specific unit of a hospital, whose performance is straightforwardly related to the quality of its own processes and with those services that are supported by it. Objective: implement and analyze the indicators of quality of an Operating Room of a hospital specialized in dermatology. Method: it is a descriptive, analytical, prospective and cross-sectional study with a quantity approach. The venue of the research was a public hospital specialized in dermatology in a city of São Paulo state. In the first stage of the study, it was sought suitable indicators to use in the Operating Room, according to the characteristics of the chosen hospital and according to the literature found in the area. The next stage, the instrument was constructed in order to collect the selected indicators. The third stage was consisted of the implementation of indicators through an educative process that assessed the background knowledge and posterior knowledge after the training. The fourth stage was related to the survey and analyze of selected indicators. Results: the research in literature and the necessities of the institution were a guide to select and elaborate an instrument tailored to collect these data. To implement, it was performed a training with 18 members of staff, in which was possible to infer that the knowledge about the issue was higher after the educative process. According to the level of significance and analyses, the following indicators were selected: rate ofcancelled surgeries, rate of infection in clean Operating Rooms, rate of accidents with nursing professionals, rate of incomplete reports performed by nurses in the perioperative period, rate of absenteeism in nursing and rate of occupation (total amount of time needed in Operating Room. ). Besides the indicators, a profile of patients and services in Operating Room was outlined to have knowledge of the profile of the institution. Product: the construction of an instrument to collect the selected indicators in literature and suitable to the Operating Room as well as the implementation of them through an educative way to the nursing team were the products of this study. Conclusions: the selection of indicators of quality in Operating Room found in literature and relevant to the characteristic of the hospital allowed the construction of a structured and practical instrument appropriated to the routine of the place, contemplating those referring to the processes of assistance and the managers. The educative process added to the team was what enabled this implementation. The analyses of the indicators after one year of collecting data highlighted the characteristics of the processes that were unknown by the members of the team what make it possible to perform directly on the main necessities of the unit, providing a standard and improvements to the Operating Room.
Introduction: the preoccupation with the quality in health organizations has been manifested through the search for better practices to meet not only the competitive market but also its customers. Therefore, it is fundamental and immediate to gather relevant pieces of information to plan, develop and evaluate the practices that are proposed and provide managers with instruments to evaluate their processes rationally and critically. The use of indicators is an applicable way to measure, compare and provide value face what is found and the established ideal. For this purpose, the collection and systematization need to be well planned in a way to facilitate the development of activities in order to improve the processes of work. The Operating Room is considered one of the most complex and specific unit of a hospital, whose performance is straightforwardly related to the quality of its own processes and with those services that are supported by it. Objective: implement and analyze the indicators of quality of an Operating Room of a hospital specialized in dermatology. Method: it is a descriptive, analytical, prospective and cross-sectional study with a quantity approach. The venue of the research was a public hospital specialized in dermatology in a city of São Paulo state. In the first stage of the study, it was sought suitable indicators to use in the Operating Room, according to the characteristics of the chosen hospital and according to the literature found in the area. The next stage, the instrument was constructed in order to collect the selected indicators. The third stage was consisted of the implementation of indicators through an educative process that assessed the background knowledge and posterior knowledge after the training. The fourth stage was related to the survey and analyze of selected indicators. Results: the research in literature and the necessities of the institution were a guide to select and elaborate an instrument tailored to collect these data. To implement, it was performed a training with 18 members of staff, in which was possible to infer that the knowledge about the issue was higher after the educative process. According to the level of significance and analyses, the following indicators were selected: rate ofcancelled surgeries, rate of infection in clean Operating Rooms, rate of accidents with nursing professionals, rate of incomplete reports performed by nurses in the perioperative period, rate of absenteeism in nursing and rate of occupation (total amount of time needed in Operating Room. ). Besides the indicators, a profile of patients and services in Operating Room was outlined to have knowledge of the profile of the institution. Product: the construction of an instrument to collect the selected indicators in literature and suitable to the Operating Room as well as the implementation of them through an educative way to the nursing team were the products of this study. Conclusions: the selection of indicators of quality in Operating Room found in literature and relevant to the characteristic of the hospital allowed the construction of a structured and practical instrument appropriated to the routine of the place, contemplating those referring to the processes of assistance and the managers. The educative process added to the team was what enabled this implementation. The analyses of the indicators after one year of collecting data highlighted the characteristics of the processes that were unknown by the members of the team what make it possible to perform directly on the main necessities of the unit, providing a standard and improvements to the Operating Room.
Descrição
Palavras-chave
Indicadores de qualidade em assistência à saúde, Gerenciamento da prática profissional, Enfermagem, Centros cirúrgicos, Indicators of quality in health assistance, Management of professional practice, Nursing, Operating rooms