SummaryObjective: To assess hospital costs associated with coronary artery bypass grafting performed on elective coronary patients, and the relation of costs with the number of grafts.Methods: Descriptive prospective study carried out at Instituto Dante Pazzanese de Cardiologia in April, May and June of 2005. Coronary patients of different ages and both genders were included. Emergency patients, patients with other associated heart conditions and reoperation cases were excluded. Appropriate forms for the operating room, early postoperative period and for the final period in the ward were developed for the initial hospitalization phase preoperatively.
A variation of material costs was observed proportional to the increase in number of bypasses performance, showing a statistical significant difference among surgerical interventions with 1, 2 and 3 cal bypasses which was not observed in surgeries with 3, 4 and 5 bypases. The direct mean cost was: CABG with 1 bypass (R$2.207,71), 2 (R$2.554,61), 3 (R$2.768,94), 4 (R$2.848,65) and 5 (R$2.884,13). The items of the perfusion material (R$1.051,24), surgical threads (R$829,98) and consumption material (R$442,40), represented those with a higher mean cost.
Atuação do enfermeiro na estruturação e implantação de uma sala operatória híbridaThe role of nurses in the structuring and implementation of a hybrid surgical room Actuación del enfermero en la estructuraci ón e implantación de una sala operatoria híbrida
Objetivo: Avaliar o conhecimento da equipe de enfermagem do centro cirúrgico sobre hipertermia maligna, antes e após aula expositiva e implantar kit padronizado para tratamento, junto aos anestesiologistas. Método: Trata-se de uma pesquisa descritiva, prospectiva com abordagem quantitativa, com a enfermagem do centro cirúrgico da Instituição sede da pesquisa, situada na cidade de São Paulo, com participação de 43 profissionais. Aplicou-se questionário pré e pós aula expositiva. Resultados: Nos dados estatísticos pós-aula, houve diferença significante (p<0,05) ao conhecimento da equipe sobre hipertermia maligna, por categoria profissional. As questões com pontuação significativa após aula foram: definição de hipertermia maligna, agentes desencadeantes e tratamento. Elaborou-se e implantou-se um kit de tratamento. Conclusão: Esta pesquisa agregou conhecimento para a equipe de enfermagem atuar com segurança e a disponibilização do kit específico proporcionou expertise e padronização de atendimento.
Objective:Identifying the average direct cost of TAVI (Transcatheter Aortic Valve Implantation) for the different access routes. Method: This is a research with a quantitative, exploratory and descriptive approach carried out in a government teaching hospital in the state of São Paulo. Results: The average direct cost of TAVI procedures by the access routes resulted in R$82,826.38 (transfemoral route), R$79,440.91 (transaortic route) and R$78,173.41 (transapical route). The transcatheter valve cost represented a percentage variation between 78.47% and 83.14% of the total cost of the procedure. The Kruskal-Wallis test was used and presented a statistically significant difference between the three access routes: p=0.008. The Bonferroni test showed a difference in the association between transfemoral and transapical routes, while no statistically significant difference was observed in association with the transaortic route. Conclusion: The results are important for formulating adequate funding policies for the hospital network and understanding the costs according to the route facilitates rationalizing resources in order for them to be guaranteed for patients who present surgical contraindication to the valve implant.
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