Protocolo eletrônico de abreviação de jejum pré-operatório: criação, aplicação e capacitação da equipe de assistência ao paciente
Electronic preoperative fasting abbreviation protocol: creation, application, and training of the patient care team
Rodrigo Costa Gonçalves; José Eduardo de Aguilar Nascimento; Marilia Arantes Rezio; Eula Cristina Machado Ferraz; Rachel de Carvalho
Resumo
Introdução: A duração do jejum pré-operatório não atende, na prática, as recomendações atuais de cuidados pré-operatórios. A implantação de protocolos clínicos de abreviação de jejum pré-operatório tem enfrentado inúmeras barreiras. O presente estudo tem como objetivo avaliar se a criação, aplicação e capacitação profissional para uso de um protocolo de abreviação de jejum, vinculado ao prontuário eletrônico, é capaz de gerenciar e reduzir o tempo de jejum pré-operatório.
Métodos: O estudo foi conduzido em dois hospitais públicos de Goiânia, Goiás, Brasil. Foi utilizada a metodologia de projetos DMAIC (Definição do Problema - Medição - Análise - Implementação e Controle). Inicialmente foi medida a duração do jejum pré-operatório nas duas instituições e analisadas as possíveis causas raízes para seu prolongamento. Com base nessa avaliação, foi desenvolvido um protocolo de abreviação do jejum, gerenciado por meio do prontuário eletrônico e a duração do jejum pré-operatório foi novamente medida. Em paralelo, foi realizado o treinamento da equipe multiprofissional para aplicação do protocolo.
Resultados: A duração de jejum pré-operatório era elevada e superior às recomendações atuais em ambos os hospitais. As causas para esse prolongamento foram identificadas e tratadas. Houve redução do tempo de jejum pré-operatório em ambas as instituições (11,50 vs 8,17 horas, p:0,000) e (8,77 vs 8,07 horas, p:0,025).
Conclusão: A construção de um protocolo, contemplando as necessidades de cada instituição, seu gerenciamento por meio de registros eletrônicos de saúde e a utilização de múltiplas metodologias de capacitação de equipes de assistência ao paciente possibilitam a redução da duração do jejum pré-operatório.
Palavras-chave
Abstract
Introduction: The preoperative fasting time does not, in practice, meet current recommendations for preoperative care. The implementation of clinical protocols for shortening preoperative fasting has faced numerous barriers. The present study aims to evaluate whether the creation, application and professional training to use a fasting abbreviation protocol, linked to the electronic medical record, is capable of managing and reducing preoperative fasting time.
Methods: The study was conducted in two public hospitals in Goiânia, Goiás, Brazil. The DMAIC project methodology (Problem Definition - Measurement - Analysis - Implementation and Control) was used. Initially, the preoperative fasting time was measured in both institutions and the possible root causes for its prolongation were analyzed. Based on this assessment, a fasting abbreviation protocol was developed, managed through the electronic medical record, and the preoperative fasting time was again measured. In parallel, training was carried out for the multidisciplinary team to apply the protocol.
Results: Preoperative fasting time was high and superior to current recommendations in both hospitals. The causes for this prolongation were identified and treated. There was a reduction in preoperative fasting time in both institutions (11.50 vs 8.17 hours, p:0.000) and (8.77 vs 8.07 hours, p:0.025).
Conclusion: The construction of a protocol, considering the needs of each institution, its management through electronic health records and the use of multiple methodologies for training patient care teams make it possible to reduce the duration of preoperative fasting.
Keywords
References
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Submitted date:
04/01/2024
Accepted date:
04/17/2025
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