Qualidade do cuidado em centro cirúrgico: ações e estratégias gerenciais para práticas seguras

The aim was to identify which directions are related to the quality of care and patient safety in the operating room. As for the method, it is an integrative review study in which bibliographic research was carried out to obtain information and approach the theme defined for the study, encouraging discussions related to research and allowing the acquisition of relevant knowledge in the field of quality of care in the operating room. The results found are correlated with the search and analysis of evidence on quality control in the surgical center, as well as the role of nurses in this environment, since their actions are fundamental for good surgical practice in all its stages. It was concluded that there are guidelines aimed at the quality of care and patient safety, even if some are still incipient and little discussed, allowing to reinforce the importance of nurse's managerial actions to increase the quality of processes from planned, organized actions and based on scientific evidence, reinforcing its responsibility in promoting best practices in surgical health care units.Objetivou-se identificar quais direcionamentos estão voltados para a qualidade do cuidado e segurança do paciente em centro cirúrgico. Quanto ao método, trata-se de um estudo de revisão integrativa em que foi realizada pesquisa bibliográfica para obtenção de informações e aproximação com o tema definido para o estudo, fomentando as discussões relacionadas a investigação e permitindo a obtenção de conhecimentos relevantes no âmbito da qualidade do cuidado em centro cirúrgico. Os resultados encontrados correlacionam-se com a busca e análise de evidências sobre o controle de qualidade no centro cirúrgico, bem como o papel do enfermeiro nesse ambiente, uma vez que as suas ações são fundamentais para a boa prática cirúrgica em todas as suas etapas. Concluiu-se que existem direcionamentos voltados para a qualidade do cuidado e segurança do paciente, mesmo que alguns sejam ainda incipientes e pouco discutidos, permitindo reforçar a importância das ações gerenciais do enfermeiro para o aumento da qualidade dos processos a partir de ações planejadas, organizadas e pautadas em evidências científicas, reforçando a sua responsabilidade na promoção de melhores práticas em unidades cirúrgicas de atenção à saúde

Worldwide Disparities in Recovery of Cardiac Testing 1 Year Into COVID-19

BACKGROUND The extent to which health care systems have adapted to the COVID-19 pandemic to provide necessary cardiac diagnostic services is unknown.OBJECTIVES The aim of this study was to determine the impact of the pandemic on cardiac testing practices, volumes and types of diagnostic services, and perceived psychological stress to health care providers worldwide.METHODS The International Atomic Energy Agency conducted a worldwide survey assessing alterations from baseline in cardiovascular diagnostic care at the pandemic's onset and 1 year later. Multivariable regression was used to determine factors associated with procedure volume recovery.RESULTS Surveys were submitted from 669 centers in 107 countries. Worldwide reduction in cardiac procedure volumes of 64% from March 2019 to April 2020 recovered by April 2021 in high- and upper middle-income countries (recovery rates of 108% and 99%) but remained depressed in lower middle- and low-income countries (46% and 30% recovery). Although stress testing was used 12% less frequently in 2021 than in 2019, coronary computed tomographic angiography was used 14% more, a trend also seen for other advanced cardiac imaging modalities (positron emission tomography and magnetic resonance; 22%-25% increases). Pandemic-related psychological stress was estimated to have affected nearly 40% of staff, impacting patient care at 78% of sites. In multivariable regression, only lower-income status and physicians' psychological stress were significant in predicting recovery of cardiac testing.CONCLUSIONS Cardiac diagnostic testing has yet to recover to prepandemic levels in lower-income countries. Worldwide, the decrease in standard stress testing is offset by greater use of advanced cardiac imaging modalities. Pandemic-related psychological stress among providers is widespread and associated with poor recovery of cardiac testing. (C) 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation