Cancelamento de cirurgias de catarata em um hospital público de referência

Magri, Micheli Patrícia de Fátima; Espíndola, Rodrigo França de; Santhiago, Marcony R.; Mercadante, Elisabeth Frolich; Júnior, Newton Kara

doi:10.1590/s0004-27492012000500007

Cited by 11 publications

(13 citation statements)

References 6 publications

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“…27 A Brazilian study reported that~21% of scheduled cataract operations are cancelled per year in the Brazilian public health system, and the main reason for cancellation is uncontrolled hypertension. 28 The fact that, in the current study, hypertension was not related to major clinical events or to higher incidence of surgical events, even in patients with initial systolic pressure ≥ 180 mm Hg, leads us to question this reason for postponing cataract surgery.…”

Section: Discussionmentioning

confidence: 52%

The impact of preoperative evaluation on perioperative events in patients undergoing cataract surgery: a cohort study

Alboim

Kliemann

Soares

et al. 2016

Eye

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Purpose Ambulatory surgery is a major area of surgical and anesthetic practice, and preoperative clinics are being increasingly used for low-risk surgical procedures. This study investigated the impact of preoperative evaluation on perioperative events in patients undergoing cataract surgery. Methods This was a retrospective cohort study of 968 consecutive patients undergoing cataract surgery. Details of medical conditions, surgical, anesthetic, and postoperative information were collected from medical records. A logistic regression model was developed using propensity score adjustment for baseline characteristics. Results Out 968 patients included, 240 (24.7%) underwent outpatient preoperative evaluation. There were no perioperative major cardiovascular events. Hypertension occurred in 319 (33%) patients, accounting for 79.7% of all adverse events. Preoperative evaluation resulted in a lower hypertension rate after adjustment for propensity score (OR = 0.6; 95% CI 0.41-0.93); no effects were observed on posterior capsule rupture and emergency visits/hospitalization within 7 days of surgery. Eighty-nine patients (9.3%) had an initial systolic pressure ≥ 180 mm Hg, which was not associated with higher risk of posterior capsule rupture (P = 0.158) or postoperative adverse events (P = 0.902). Median waiting time to surgery was 6 and 2 months for evaluated and non-evaluated patients, respectively (Po0.001). Conclusions In the context of low-risk surgery and no major perioperative and postoperative outcomes, it appears that outpatient preoperative evaluation has no role in reducing adverse events in cataract surgery candidates. Despite fewer hypertensive episodes observed in evaluated patients, these episodes were not associated with any medical or surgical outcomes.

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Section: Discussionmentioning

confidence: 52%

The impact of preoperative evaluation on perioperative events in patients undergoing cataract surgery: a cohort study

Alboim

Kliemann

Soares

et al. 2016

Eye

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“…The study pointed out that those expenses could be avoidable, as long as the problems regarding flaws in administrative planning and mismanagement of the SC were fixed (1) . Several factors contribute to surgical cancellations: patient absence (1,10) ; unfavorable clinical conditions, mainly regarding decompensated chronic diseases, such as systemic arterial hypertension (SAH) and diabetes, in addition to lack of preoperative clinical exams (1,(10)(11) ; overrun of surgery time (10)(11)(12) ; non-availability of hospital bed (10) ; lack of articulation between surgical scheduling and the multipurpose team and a lack of computerization, which may cause errors leading to unnecessary cancellations (13)(14) ; type of hospital (university hospitals) (15) and of surgery (general surgery) (16) . Among the strategies proposed by the literature to reduce surgery cancellations are: pre-anesthetic or preoperative consultations (1,17) ; telephone confirmation of patient attendance two days before the procedure (10) ; restructuring of the work process, involving healthcare staff, information technology and mid-level professionals (18) .…”

Section: Introductionmentioning

confidence: 99%

Cancellation of elective surgeries in a Brazilian public hospital: reasons and estimated reduction

Santos

Bocchi

2017

Rev. Bras. Enferm.

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Objective: To characterize cancellations of elective surgeries according to clinical and non-clinical reasons, as well as to verify seasonal influence and determine the estimated reduction of the index. Method: Quantitative, descriptive and retrospective study with secondary data extracted from the Public Hospital of the State of São Paulo database. Results: Out of the 8,443 (100%) elective surgeries scheduled, 7,870 (93.21%) were performed and 573 (6.79%) were canceled. Out of these 573 (100%) people, 48.33% were canceled for clinical reasons and 46.40% were for non-clinical reasons. Among the non-clinical reasons for surgery cancellations, those related to medical reasons stood out: at the request of the surgeon/change of approach (17.93%), followed by non-hospitalized patient (8.96%). There was no indication of seasonality regarding the reasons for cancellation in the assessed period. Conclusion: Although the rate of elective surgeries cancellations is lower than that of other hospitals with similar characteristics, it is still possible to reduce it from 6.79% to 1.36%, considering that 80% of the reasons for cancellation are avoidable.

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“…A qualidade dos registros sobre o atendimento prestado aos pacientes é uma preocupação crescente nas instituições, considerando-se que informações insuficientes afetam e interpõem-se à qualidade do cuidado, especialmente quando referem-se aos dados de identificação do paciente que, quando incompletos, podem comprometer a sua segurança (22) . O indicador absenteísmo da enfermagem revelou taxas inferiores a outras realidades brasileiras (23,24) .…”

Section: Discussionunclassified

Indicadores De Qualidade Em Centro Cirúrgico Especializado Em Dermatologia

et al. 2020

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Objetivo: identificar e caracterizar os indicadores de qualidade mais frequentes utilizados em um Centro Cirúrgico público especializado em dermatologia.Método: estudo transversal seccional, pelo qual fez-se um levantamento, com registros diários, dos mais frequentes indicadores entre os 20 existentes na unidade, no período de agosto de 2015a julho de 2016. Considerou-se: médias, medianas, valores mínimos/máximos, desvios padrões, frequências simples e percentuais. O valor de p<0,05 foi considerado como nível de signfiicância.Resultados: das 595 cirurgias eletivas, destacaram-se as ambulatoriais (87,9%), as dermatológicas (81,3%), em pacientes do sexo masculino (52,6%), com média de 54,9 anos. Os cinco indicadores mais frequentes foram: cirurgias suspensas (17,6%); registros de enfermagem incompletos (14%); absenteísmo (6,5%); infecção em sítio cirúrgico em cirurgias limpas (2,7%) e acidentes de trabalho (2,2%).Conclusões: a identificação e a caracterização dos indicadores de qualidade proporcionaram visibilidade aos processos locais, viabilizando a tomada de decisões e o aperfeiçoamento dos serviços prestados.

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Cancelamento de cirurgias de catarata em um hospital público de referência

Cited by 11 publications

References 6 publications

The impact of preoperative evaluation on perioperative events in patients undergoing cataract surgery: a cohort study

The impact of preoperative evaluation on perioperative events in patients undergoing cataract surgery: a cohort study

Cancellation of elective surgeries in a Brazilian public hospital: reasons and estimated reduction

Indicadores De Qualidade Em Centro Cirúrgico Especializado Em Dermatologia

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