NURSING: THE IMPORTANCE FOR HIGH QUALITY SURGERY Demographics and Labor Market VANESSA DE BRITO POVEDA Regional Meeting - The Lancet Latin America SÃO.

Apresentação em tema: "NURSING: THE IMPORTANCE FOR HIGH QUALITY SURGERY Demographics and Labor Market VANESSA DE BRITO POVEDA Regional Meeting - The Lancet Latin America SÃO."— Transcrição da apresentação:

1 NURSING: THE IMPORTANCE FOR HIGH QUALITY SURGERY Demographics and Labor Market VANESSA DE BRITO POVEDA Regional Meeting - The Lancet Latin America SÃO PAULO 2014

2 What is ‘quality surgery’?  The safest care and best outcomes to the patients  preventing complications  improving surgical care  reducing costs  American College of Surgeons, 2010

3 First global patient safety challenge  2005 – 2006 WHO, 2003

4 Second global patient safety challenge  2007 – 2008 WHO, 2008

5

6 HOW FAR ARE WE FROM THE ACHIEVEMENT OF “HIGH QUALITY SURGERY”?

7 Surgical procedures - Brazil, 2009 Local MODERATE COMPLEXITY SURGERY HIGH COMPLEXITY SURGERY SURGICAL PROCEDURES N%N%N% North 24.35096,68493,425.199100 Northeast 84.33393,16.2406,990.573100 Midwest20.75491,91.8418,122.595100 Southeast 115.33589,014.31911,0129.654100 South 46.66185,38.04214,754.703100 Brazil291.43390,331.2919,7322.724100 Source: www.datasus.gov.brwww.datasus.gov.br

8 Number of health professionals (medical doctor and nurse)/ 1000 inhabitant – Brazil 1991, 1996 e 1999 Local 199119961999 PhysicianNursePhysicianNursePhysicianNurse Brazil1,30,41,30,41,40,5 North0,60,20,60,30,60,3 Northeast0,80,30,80,30,80,4 Southeast1,90,51,80,52,10,5 South1,20,41,20,41,40,5 Midwest1,30,31,30,41,30,4 Source: Ministério da Saúde/CGRH e Conselhos Profissionais Bases para cálculo da população: IBGE, Censos 1991 e 2000; Contagem da População, 1996

9 Nursing professionals - Brazil  Nursing professionals: 1.856.686  (nurses, nursing technician, nursing auxiliary)  Nurses: 340.387  COFEN, 2012

10 Distribution of nurses - Brazil Total 340.387 70.499 19.860 180.781 20.439 48.808 COFEN, 2012

11 1 nursing professional/ 1000 inhabitants  Brazil:  8,51 nursing professionals/1000 inhabitants  1,78 nurses/ 1000 inhabitants  3,72 nursing technician/ 1000 inhabitants  2,94 nursing auxiliary/ 1000 inhabitants  COFEN, 2011

12 PERIOPERATIVE NURSES - BRAZIL Local Number of Perioperative Nurses Number of nurses/100 surgical procedures North 450,2 Northeast 1360,2 Midwest 420,2 Southeast 4080,3 South 970,2 Brazil7280,2 Source: www.datasus.gov.br-2011

13 Is 99,9% a standard of safety?  0,1% errors could mean:  20.000 wrong medicine prescriptions/year  15.000 accidental fall of babies at hospitals/year  500 wrong surgery/week  2.000 lost documents/hour to our patients= 100% Rosenthal, Sutcliffe, 2002

14 WHERE DO WE HAVE TO INVEST?

15  STERILIZATION  Good quality infrastructure First step: Cleaning process Termodisinfection and ultrasonic cleaner

16 Perioperative  Preoperative and postoperative  A large number of qualified nurse professionals (perioperative nurses)  Surgical safety checklist  Prevention of surgical site infection  Postdischarge surveillance  Zinn, 2013

17 Intraoperative  Maintain normothermia  Use appropriative hair removal with electric clippers  Use appropriative selection and timing of preoperative antibiotics  Maintain glucose levels during surgery  Zinn, 2013

18 Thank you for your attention! E-mail: vbpoveda@usp.br

19 References  American College of Surgeons. Lessons Learned in the Pursuit of Quality Surgical Health Care. [Internet]. American College of Surgeons, 2010. [citado 2014 Ago 6]. Available in: https://www.facs.org/quality-programs/about/inspiring-quality/lessons-learned  World Health Organization. (WHO). Word Alliance for Patient Safety. Guidelines on hand hygiene in health care. 2003.  World Health Organization. (WHO). Word Alliance for Patient Safety. Guidelines Safe Surgery. First Edition. 2008.  Conselho Federal de Enfermagem. Recomendação encaminhada ao MEC repercute nas redes sociais. [Internet]. COFEN, 2012. [citado 2014 Ago 6]. Available in: http://www.cofen.gov.br/cofen-recomenda-que-cursos-de-enfermagem-a-distancia-nao-sejam-reconhecidos_16039.html?print=1http://www.cofen.gov.br/cofen-recomenda-que-cursos-de-enfermagem-a-distancia-nao-sejam-reconhecidos_16039.html?print=1  Zinn J. Surgical patients: a vulnerable population. AORN J 2013. 98(6): 647-52.  www.datasus.gov.br