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      Implementación del listado de verificación preoperatorio de enfermería para cirugía segura Translated title: Nursing preoperative checklist for safe surgery

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          Abstract

          Resumen Antecedentes. La seguridad en la atención de los pacientes es un aspecto prioritario en la organización y funcionamiento de todo sistema de salud. La valoración de enfermería en las salas de internación permite detectar dificultades o problemas en el preoperatorio que pueden poner en riesgo la vida del paciente o el resultado esperado de la intervención. Se deben generar protocolos que garanticen seguridad para los pacientes disminuyendo al máximo los errores. Objetivo. Implementar la lista de verificación preoperatoria de enfermería para disminuir los errores en el ingreso de pacientes a quirófanos. Lugar. Hospital Universitario-. División Quirófanos - Departamento de Cirugía - Dirección de Enfermería. Población. Pacientes internados para cirugías programadas. Método. Observacional, exploratorio, longitudinal prospectivo con análisis retrospectivo. Implementación preoperatoria de lista de verificación en sala de internación por enfermería. Resultados. En Mayo de 2018 se operaron 355 pacientes en los quirófanos centrales. Hubo 183 errores de un total de 158 cirugías programadas. La falla más frecuente fue el ingreso de pacientes con ropa interior o ropa de cama en 59 (32,2%), seguido por falta de gorro o cofia en 22 (12%), e ingreso de pacientes con prótesis dental en 21 (11,5%). En la segunda etapa aún con la planilla de verificación de enfermería preoperatoria implementada persistieron los errores en un 48 %. Conclusión. se deben promover acciones específicas para que los equipos quirúrgicos alcancen de forma sistemática las medidas de seguridad esenciales sin poner en riesgo la vida y bienestar de los pacientes quirúrgicos.

          Translated abstract

          Abstract Background. The safety of patient care is a priority aspect in the organization and functioning of all health systems with direct implications on the quality of care. The assessment of nursing in the internment rooms allows to detect difficulties or problems in the preoperative that can endanger the life of the patient or the expected outcome of the intervention. This is where protocols must be generated to ensure safety for patients, minimizing errors. Objective. To implement the pre-operative nursing checklist to reduce errors in the admission of patients to operating room. Setting. University Hospital. Surgical Division - Department of Surgery - Nursing management. Population. internal patients for scheduled surgeries. Method. Observational, exploratory, longitudinal prospective with retrospective analysis. Checklist preoperative nursing implementation. Results. In May 2018, 355 patients were operated in the central operating rooms. 183 errors were found on 158 surgeries scheduled in a first stage. The most frequent failure was the admission of patients with underwear or bedding 59 (32.2%), followed by lack of cap or cap 22 (12%), and admission of patients with dental prosthesis 21 (11.5%). In the second stage, the nursing check list form was implemented but which could reduce the number of errors in the preoperative period to 48%. Conclusion. Specific actions should be promoted so that surgical teams systematically reach essential safety measures that jeopardize the life and well-being surgical patients.

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          New WHO recommendations on preoperative measures for surgical site infection prevention: an evidence-based global perspective

          Surgical site infections (SSIs) are among the most preventable health-care-associated infections and are a substantial burden to health-care systems and service payers worldwide in terms of patient morbidity, mortality, and additional costs. SSI prevention is complex and requires the integration of a range of measures before, during, and after surgery. No international guidelines are available and inconsistencies in the interpretation of evidence and recommendations of national guidelines have been identified. Given the burden of SSIs worldwide, the numerous gaps in evidence-based guidance, and the need for standardisation and a global approach, WHO decided to prioritise the development of evidence-based recommendations for the prevention of SSIs. The guidelines take into account the balance between benefits and harms, the evidence quality, cost and resource use implications, and patient values and preferences. On the basis of systematic literature reviews and expert consensus, we present 13 recommendations on preoperative preventive measures.
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            Defining medical error.

            Medical errors represent a serious public health problem and pose a threat to patient safety. As health care institutions establish "error" as a clinical and research priority, the answer to perhaps the most fundamental question remains elusive: What is a medical error? To reduce medical error, accurate measurements of its incidence, based on clear and consistent definitions, are essential prerequisites for effective action. Despite a growing body of literature and research on error in medicine, few studies have defined or measured "medical error" directly. Instead, researchers have adopted surrogate measures of error that largely depend on adverse patient outcomes or injury (i.e., are outcome-dependent). A lack of standardized nomenclature and the use of multiple and overlapping definitions of medical error have hindered data synthesis, analysis, collaborative work and evaluation of the impact of changes in health care delivery. The primary objective of this review is to highlight the need for a clear, comprehensive and universally accepted definition of medical error that explicitly includes the key domains of error causation and captures the faulty processes that cause errors, irrespective of outcome.
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              Incidencia y Evitabilidad de Eventos Adversos en Pacientes Hospitalizados en tres Instituciones Hospitalarias en Colombia, 2006

              Objetivo Determinar incidencia, clasificación, evitabilidad e impacto de los Eventos Adversos (EA) para establecer su importancia como problema en algunos hospitales en Colombia. Metodología Cohorte prospectiva de pacientes hospitalizados al menos 12 horas en 3 instituciones generales en Colombia. Se excluyeron pacientes psiquiátricos, presencia del EA antes del ingreso a la hospitalización índice. Con una diferencia estimada del 1 % (complejidad alta y media), significancia: 0,05 %, poder: 80 % relación 2:1 se requerían mínimo 6 557 pacientes. Fuente de información: historia clínica Fase I: traducción y adaptación de formularios. Fase II: vigilancia activa de eventos de tamización. Fase III: evaluación de la asociación del EA con el cuidado proveído, por un comité de especialistas, Variables: edad, género y tipo de afiliación al sistema de seguridad social, incidencia acumulada de EA, temporalidad, evitabilidad y discapacidad resultante naturaleza del EA. Resultados Fueron evaluados 6 688 sujetos durante el periodo de vigilancia. Se detectaron 505 pacientes con eventos de tamización positivos (7,9 % IC95 % 7,3-8,6). Un total de 310 sujetos presentaron al menos un evento adverso; Incidencia acumulada: (4,6 % IC95 % 4,1-5,1) durante la hospitalización. De estos se consideró evitable el evento adverso en 189 sujetos (61 %, IC95 % 55-66). Ocurrió discapacidad permanente en 1,3 %. La mortalidad asociada al evento adverso fue de 6,4 % (20/310). Se incrementó la hospitalización como consecuencia del EA un total de 1 072 días. Conclusiones La incidencia de eventos adversos evitables fue relevante en los tres hospitales de Colombia.
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                Author and article information

                Journal
                jonnpr
                Journal of Negative and No Positive Results
                JONNPR
                Research and Science S.L. (Madrid, Madrid, Spain )
                2529-850X
                2020
                : 5
                : 8
                : 792-805
                Affiliations
                [4] Buenos Aires Buenos Aires orgnameHospital de Clínicas José de San Martín orgdiv1Departamento de Cirugía Argentina
                [2] Buenos Aires Buenos Aires orgnameHospital de Clínicas José de San Martín orgdiv1Dirección de Enfermería Argentina
                [3] Buenos Aires Buenos Aires orgnameHospital de Clínicas José de San Martín orgdiv1Dirección de Servicios Generales Argentina
                [1] Buenos Aires Buenos Aires orgnameHospital de Clínicas José de San Martín orgdiv1División Quirófanos Argentina
                Article
                S2529-850X2020000800003 S2529-850X(20)00500800003
                10.19230/jonnpr.3386
                c10b1fce-7de7-4abe-bf95-c8acf1b23a2c

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 09 November 2019
                : 29 December 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 23, Pages: 14
                Product

                SciELO Spain

                Categories
                Original

                verificación preoperatoria,cirugía segura,enfermería,safe surgery,preoperative checklist,nursing

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