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NURSING: THE IMPORTANCE FOR HIGH QUALITY SURGERY Demographics and Labor Market

NURSING: THE IMPORTANCE FOR HIGH QUALITY SURGERY Demographics and Labor Market. VANESSA DE BRITO POVEDA. Regional Meeting - The Lancet Latin America. SÃO PAULO 2014. What is ‘quality surgery’?. The safest care and best outcomes to the patients preventing complications

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NURSING: THE IMPORTANCE FOR HIGH QUALITY SURGERY Demographics and Labor Market

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

  6. Surgical procedures - Brazil, 2009 Source: www.datasus.gov.br

  7. Number of health professionals (medical doctor and nurse)/ 1000 inhabitant – Brazil1991, 1996 e 1999 Source: Ministério da Saúde/CGRH e Conselhos ProfissionaisBases para cálculo da população: IBGE, Censos 1991 e 2000; Contagem da População, 1996

  8. Nursing professionals - Brazil • Nursing professionals: 1.856.686 • (nurses, nursing technician, nursing auxiliary) • Nurses: 340.387 • COFEN, 2012

  9. Distributionof nurses -BrazilTotal 340.387 19.860 70.499 20.439 180.781 48.808 COFEN, 2012

  10. 1 nursing professional/ 1000 inhabitants • Brazil: • 8,51 nursingprofessionals/1000 inhabitants • 1,78 nurses/ 1000 inhabitants • 3,72 nursingtechnician/ 1000 inhabitants • 2,94 nursingauxiliary/ 1000 inhabitants • COFEN, 2011

  11. PERIOPERATIVE NURSES - BRAZIL Source: www.datasus.gov.br-2011

  12. 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

  13. WHERE DO WE HAVE TO INVEST?

  14. WHERE DO WE HAVE TO INVEST? • STERILIZATION • Good quality infrastructure • First step: Cleaning process • Termodisinfection and ultrasonic cleaner

  15. 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

  16. 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

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

  18. 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=1 • Zinn J. Surgical patients: a vulnerable population. AORN J 2013. 98(6): 647-52. • www.datasus.gov.br

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