Saberes e práticas de acompanhantes sobre complicações respiratórias pós-cirúrgicas no idoso, compartilhados com a enfermeira Conocimientos y prácticas de acompañantes sobre complicaciones respiratorias posquirúrgicas en ancianos, compartidas con la enfermera Knowledge and experiences of caregivers for post-surgical respiratory complications in elderly people, shared with the nurse

Pesquisa convergente-assistencial cujo objetivo foi analisar saberes e práticas de acompanhantes voltados à prevenção de complicações respiratórias pós-cirúrgicas no idoso, com vistas a traçar um plano de cuidados a ser implementado para esses clientes. As bases teórico-conceituais pautaram-se na pedagogia problematizadora de Freire. Os sujeitos foram 14 acompanhantes de idosos em pré-operatório. Utilizou-se técnica de entrevista individual e observação participante, e análise de conteúdo temática. Os resultados revelaram que as acompanhantes acumulam saberes, acerca de cuidados básicos no pós-operatório, capazes de prevenir problemas respiratórios. Pela dialogicidade construiu-se um plano de cuidados compartilhado a ser realizado com o idoso, consequência da integração de saberes e práticas dos acompanhantes com os da enfermeira-pesquisadora na visita pré-operatória. Resultaram novas ou revisitadas práticas, culminando em um cuidado congruente às reais necessidades dos clientes e seus acompanhantes, tornando-os parceiros no processo de cuidar.<br>Investigación convergente y asistencial, con objetivo de analizar los conocimientos y prácticas de acompañantes dirigidos a la prevención de complicaciones respiratorias posquirúrgicas en el anciano, a fin de elaborar un plan de cuidados para ser implementado con estos clientes. Las bases teórica y conceptual se pautaron en la pedagogía problematizada de Paulo Freire. Los sujetos fueron 14 acompañantes de clientes ancianos en el período preoperatorio. Se utilizó la técnica de entrevistas individuales y de observación participante y análisis de contenido temático. Los resultados revelaron que las acompañantes acumulan saber, acerca de cuidados básicos en el pos-operatorio, capaces de prevenir problemas respiratorios. A partir de conversaciones, se construyó un plan de cuidados compartido a ser realizado con el anciano, resultante de la integración de conocimientos y prácticas de los acompañantes con los de la enfermera/investigadora en la visita preoperatoria. Resultaron en nuevas o revisitadas prácticas, culminando en un cuidado congruente a las reales necesidades de los clientes y sus acompañantes, tornándolos compañeros en el proceso de cuidar.<br>This is a convergent-assistance research, whose goal was to analyze the knowledge and experiences of caregivers focused on the prevention for post-surgical respiratory in the elderly people, in order to develop a care plan to be implemented with these clients. The theoretical and conceptual bases founded on the Critical Pedagogy of Freire. The subjects were 14 caregivers of elderly on a pre-surgical period. The technique used was individual interviews, participant observation and the analysis of a thematic content. The results showed that the caregivers accumulate knowledge, concerning to the basic care in the post-surgical, able to prevent respiratory problems. Through the dialogue it was developed a shared care plan to be realized with the elderly, as a result from the integration of the knowledge and experiences from the caregivers and from the nurse-researcher on a pre-surgical visit. The result was the new or revisited practices, culminating into a congruent care to the real needs of the clients and theirs companions, becoming partners in the care process

Preoperative nasopharyngeal swab testing and postoperative pulmonary complications in patients undergoing elective surgery during the SARS-CoV-2 pandemic.

BACKGROUND: Surgical services are preparing to scale up in areas affected by COVID-19. This study aimed to evaluate the association between preoperative SARS-CoV-2 testing and postoperative pulmonary complications in patients undergoing elective cancer surgery. METHODS: This international cohort study included adult patients undergoing elective surgery for cancer in areas affected by SARS-CoV-2 up to 19 April 2020. Patients suspected of SARS-CoV-2 infection before operation were excluded. The primary outcome measure was postoperative pulmonary complications at 30 days after surgery. Preoperative testing strategies were adjusted for confounding using mixed-effects models. RESULTS: Of 8784 patients (432 hospitals, 53 countries), 2303 patients (26.2 per cent) underwent preoperative testing: 1458 (16.6 per cent) had a swab test, 521 (5.9 per cent) CT only, and 324 (3.7 per cent) swab and CT. Pulmonary complications occurred in 3.9 per cent, whereas SARS-CoV-2 infection was confirmed in 2.6 per cent. After risk adjustment, having at least one negative preoperative nasopharyngeal swab test (adjusted odds ratio 0.68, 95 per cent confidence interval 0.68 to 0.98; P = 0.040) was associated with a lower rate of pulmonary complications. Swab testing was beneficial before major surgery and in areas with a high 14-day SARS-CoV-2 case notification rate, but not before minor surgery or in low-risk areas. To prevent one pulmonary complication, the number needed to swab test before major or minor surgery was 18 and 48 respectively in high-risk areas, and 73 and 387 in low-risk areas. CONCLUSION: Preoperative nasopharyngeal swab testing was beneficial before major surgery and in high SARS-CoV-2 risk areas. There was no proven benefit of swab testing before minor surgery in low-risk areas