m-Health in the Surgical Context: Prospecting, Review and Analysis of Mobile Applications

Abstract

Background m-Health initiatives can show an opportunity to improve the identification, prevention and management of certain diseases. Most health-care applications aims at chronic noncommunicable diseases care, and it is necessary to seek evidence from applications intended for surgical patient care, either before, during or after hospitalization. Objective: The Study Aims to identify and analyze, from the literature review and prospecting, applications for smartphones developed to assist the surgical patient. Methods: A descriptive-exploratory study developed in two sequential phases. The first one corresponded to an integrative review of the literature in the databases PubMed, Web of Knowledge, Europe PMC database and Cumulative Index to Nursing and Allied Health Literature database. The second phase corresponded to an exploration of applications in the European Patent Office, United States Patent and Trademark Office (USPTO), Free Patents Online, Canadian Intellectual Property Office and World Intellectual Property Organization. In both phases, we do not restrict the results by year of publication/registration or language. At each stage, the selected studies/patents were analyzed and pre-selected, according to the inclusion and exclusion criteria, by reading their titles and abstracts. Subsequently, we analyzed those with the potential of participation in the study, evaluating the answer to the research question, as well as the type of research, objectives, sample, method, outcomes, results and conclusion. Finally, the articles/patents record found were read in full. Results In the databases, 14 studies that presented some application for smartphone aimed at the surgical patient were selected. Most of them were in PubMed (64.3%), published in English (100%). Regarding origin, 28.6% of the texts are from the United States of America, 14.3 from Sweden and 14.3 from Canada. On the other hand, in patent databases, 10 registries were selected, 60% in the USPTO patent base, hosted in hybrid systems (iPhone and Android) and developed in the last 5 years (2014-1018) (80%). In general, there is a series of applications aimed at surgical patients, such as targets and/or users, mainly focused on the exchange of text and image messages but concentrated on assisting the physician/health team in the preparation of the patient during the procedure or post discharge. It is necessary to invest in the creation of technologies that aim to monitor these patients, especially in post discharge. Conclusion The characteristics of applications indicate a strong hospital centered tendency in relation to its purpose, having the surgeon as the main user and the surgical patient as the main target. The applications are still focused on optimizing diagnostics or functions, and no initiatives are identified to monitor the patient in a non-hospital environment.

Monitorização de complicações pós-operatórias no ambiente domiciliar

“…Pelo exposto, fica claro que a transição do hospital para o domicílio pode ser um período de incerteza e de risco para muitos pacientes. Dessa forma, um correto follow-up torna-se uma ferramenta fundamental para assegurar que a continuidade de cuidados seja garantida com a mesma qualidade que seria em um ambiente hospitalar (4) . Nesse sentido, os enfermeiros são os profissionais que estão melhor posicionados para assegurar os cuidados fora das organizações hospitalares (5,17) .…”

“…No entanto, a inexistência de um sistema padronizado de vigilância e das complicações pós-alta dificulta estabelecer um panorama real da situação (3)(4)(5) , em termos de prevalência, intervenções e desfecho. Além disso, não há uma recomendação padronizada por órgãos nacionais de vigilância acerca do processo de vigilância e notificação dessas complicações (4)(5) . Assim, entende-se que ainda há um "gap" entre o paciente pós-cirúrgico no domicílio e a equipe de saúde.…”

Nursing care of the chronic renal patient on hemodialysis using double lumen catheter / Cuidados de enfermagem ao paciente renal crônico em hemodiálise em uso de cateter duplo lúmen

“…Some of these injuries are preventable, and are directly related to nursing care, which is directly involved with the care of the CDL, as it is the professional who frequently handles this device. [1][2][3][4] CDL infection is one of the most frequent complications and is associated with intrinsic factors linked to the patient himself, such as the migration of microorganisms from the patient's flora, as well as the state of immunosuppression. Exogenous factors are linked to environmental conditions, especially the transfer of microorganisms from the hands of caregivers, both at the time of catheter implantation and during subsequent care.…”

Patient self-care with double catheter lumen for hemodialization: validation of instructional folder

“…Because of the possibility of complications, the use of venous catheters for hemodialysis is associated with high rates of morbidity and mortality in patients with chronic renal failure. One of the most frequent complications is infection, which has its incidence varying according to the type of catheter, length of time, technique, and insertion site, used solutions and care of handling and maintenance carried out by the nursing staff (Silva et al, 2018;Sousa et al, 2019). In Brazil, catheter-related infection for hemodialysis ranges from 3.2 to 40.4 events per thousand days of catheter and the related mortality ranges from 6.7 to 75.0%.…”