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Inovação informática de atendimento holístico do idoso no bloco operatório
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Abstract(s)
A cirurgia, como ferramenta crucial na resolução de problemas nos idosos, na melhoria de funções e qualidade de vida, despertou-nos para a construção de um programa de inovação informática de atendimento holístico do idoso no bloco operatório, visando reconstruir as práticas de enfermagem perioperatória e adequar as intervenções dos enfermeiros às necessidades dos idosos atendidos no bloco operatório do Hospital Dr. Nélio Mendonça. Para a sua consecução efetuámos dois estudos: o primeiro “estudo piloto”, quantitativo e descritivo, teve por objeto compreender as características e avaliar o estado funcional dos idosos (n= 120). Verificou-se que a média do “Índice de Barthel” foi de 63,9 e à medida que a idade aumenta, aquele diminui. O segundo, de tipo quantitativo e correlacional, teve como objetivo avaliar o programa de atendimento ao cliente no bloco operatório, com enfoque no idoso em período perioperatório e nos enfermeiros perioperatórios. Para a sua consecução, efetuou-se uma observação estruturada às práticas de enfermagem perioperatória (n=111), antes e após a aplicação do referido programa, e, simultaneamente, averiguamos indicadores relacionados com o idoso em fase perioperatória (n=460), utilizando variáveis clínicas e variáveis associadas a escalas de medida, nomeadamente: Índice de Barthel, avaliação da dor aguda pósoperatória, ansiedade-estado de Spielberger for Adults, the Amestardâ Preoperative Anxiety and Information, avaliação do risco de queda e avaliação do risco de úlceras por pressão. Decorrente da implementação do programa, observaram-se melhorias significativas na performance dos enfermeiros, entre as quais, a realização da visita pré e pós-operatória (86,7%), a avaliação da ansiedade pré-operatória (86,7%), a avaliação da dor aguda pós-operatória (100%), a realização de registos completos pré e pós-operatórios (86,7%; 96,7%). No atendimento integral dos clientes idosos, constatou-se que a maioria é do sexo feminino (57,8%; 63%) com idades entre os 65-69 anos (36,5%; 30%). A especialidade com maior representatividade foi a cirurgia geral (34,3%; 29,1%), do tipo Major (70,0%; 78,7%). A maioria dos idosos foi submetida a anestesia geral (58,7%; 59,6%) sendo o tempo médio de recobro de 3 horas e 31 minutos, na 1ª fase, e 3 horas e 10 minutos, na 2ª fase. O nível de ansiedade pré-operatória e a dor aguda evidenciaram uma diminuição significativa no pós-operatório na 2ª fase. Os resultados comprovaram a aplicabilidade e exequibilidade deste programa, sendo a sua validação efetuada apenas nos clientes idosos.
Surgery, as a crucial tool in solving problems in the elderly, in the improvement and quality of life, arose our awareness to construct a computer programme for elderly care in surgery, in order to rebuild the perioperative nursing practices, adapt the interventions of nurses to the needs of the elderly in surgery of the Hospital Dr. Nélio Mendonça. Two studies were carried out for its achievement. The first "pilot study", quantitative and descriptive, being its purpose to understand the features and evaluate the functional status of the elderly (paragraph 120). It was found that the average "Barthel Índex" was 63.9 and as age increases that decreases. The second type was both quantitative and correlational aimed to assess the customer service programme in surgery, with a focus on the elderly in perioperative period and on perioperative nurses. For its achievement a structured observation of perioperative nursing practices was carried out (paragraph 111) before and after the implementation of this programme and, at the same time to discover indicators related to the elderly in the perioperative stage (n460) using clinical variables and variables associated with measuring scales, including Barthel index, rating scales acute postoperative pain, anxiety scale-Spielberger State for Adults, The Preoperative Anxiety and Information Amsterdam Scale, the scale of assessment of the risk of falling and the scale of assessment of the risk of pressure ulcers. Arising from the implementation of the programme, we observed significant improvements in nurses' performance, including the performance of pre and postoperative visit (86.7), the evaluation of preoperative anxiety (86.7), the assessment of acute postoperative pain (100), the realization of full preoperative and postoperative records (86.7; 96.7). In the comprehensive care of the elderly patients, it was found that the majority are female (57.8; 63) aged 65-69 years (36.5; 30). The medical specialty with the highest representativeness was the General Surgery (34.3; 29.1), Major type (70.0; 78.7). Most elderly underwent general anesthesia (58.7; 59.6) being the average time of recovery 3:0 and 31 minutes in the first phase and 3:0 and 10 minutes in the second phase. The preoperative anxiety level and the acute pain showed a significant decrease in the postoperative period in the second phase. The results showed the applicability, feasibility and validation of this programme, performed only on elderly patients.
Surgery, as a crucial tool in solving problems in the elderly, in the improvement and quality of life, arose our awareness to construct a computer programme for elderly care in surgery, in order to rebuild the perioperative nursing practices, adapt the interventions of nurses to the needs of the elderly in surgery of the Hospital Dr. Nélio Mendonça. Two studies were carried out for its achievement. The first "pilot study", quantitative and descriptive, being its purpose to understand the features and evaluate the functional status of the elderly (paragraph 120). It was found that the average "Barthel Índex" was 63.9 and as age increases that decreases. The second type was both quantitative and correlational aimed to assess the customer service programme in surgery, with a focus on the elderly in perioperative period and on perioperative nurses. For its achievement a structured observation of perioperative nursing practices was carried out (paragraph 111) before and after the implementation of this programme and, at the same time to discover indicators related to the elderly in the perioperative stage (n460) using clinical variables and variables associated with measuring scales, including Barthel index, rating scales acute postoperative pain, anxiety scale-Spielberger State for Adults, The Preoperative Anxiety and Information Amsterdam Scale, the scale of assessment of the risk of falling and the scale of assessment of the risk of pressure ulcers. Arising from the implementation of the programme, we observed significant improvements in nurses' performance, including the performance of pre and postoperative visit (86.7), the evaluation of preoperative anxiety (86.7), the assessment of acute postoperative pain (100), the realization of full preoperative and postoperative records (86.7; 96.7). In the comprehensive care of the elderly patients, it was found that the majority are female (57.8; 63) aged 65-69 years (36.5; 30). The medical specialty with the highest representativeness was the General Surgery (34.3; 29.1), Major type (70.0; 78.7). Most elderly underwent general anesthesia (58.7; 59.6) being the average time of recovery 3:0 and 31 minutes in the first phase and 3:0 and 10 minutes in the second phase. The preoperative anxiety level and the acute pain showed a significant decrease in the postoperative period in the second phase. The results showed the applicability, feasibility and validation of this programme, performed only on elderly patients.
Description
Keywords
Perioperatório Idoso Programa informático Enfermagem perioperatória Perioperative Elderly Computer programme Perioperative nursing . Escola Superior de Saúde