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Introdução: Este estudo tomou como ponto de partida o Enhanced Recovery After Surgeryâ (ERASâ) e consistiu no planeamento, implementação de uma consulta de enfermagem pré-operatória e sua avaliação. O ERASâ é um programa de cuidados perioperatórios que promove a otimização pré-operatória do cliente e a minimização do stress provocado pela cirurgia para obter melhores resultados em saúde. Por sua vez, a consulta pretende conhecer melhor o cliente e fornecer-lhe informação para que possa desempenhar um papel mais ativo na sua recuperação. Objetivos: Definiram-se três objetivos gerais, (1) estruturar (2) implementar e (3) avaliar a consulta. Para esta avaliação foram elencados objetivos específicos aos principais focos de avaliação da consulta: a informação transmitida, a experiência do cliente com o processo cirúrgico; a responsabilidade e participação do cliente no processo cirúrgico; a satisfação do cliente, as implicações na recuperação da autonomia na mobilização e as implicações no tempo médio de internamento. Método: Trata-se de um estudo descritivo, longitudinal de natureza quantitativa. O desenho de estudo dividiu-se em três partes: estruturação, operacionalização e avaliação da consulta. Para proceder a esta avaliação foram utilizados dois instrumentos de recolha de dados: um questionário e uma plataforma de auditoria de resultados clínicos. Foram consideradas duas amostras não probabilísticas de clientes, uma antes da implementação do programa ERASâ e outra com implementação do programa e comparados os resultados obtidos de acordo com os focos de avaliação. O tratamento de dados foi realizado através do Statistical Package for the Social Sciencesâ (SPSSâ) e os resultados apresentados de acordo com objetivos específicos. Resultados: No que respeita à importância das informações transmitidas inferiu-se que 59,1% dos clientes consideraram as informações transmitidas muito importantes e 34,4% importantes. 74,2% dos clientes relataram ter ficado muito satisfeitos com a consulta e 19,4% satisfeitos. 100,0% dos clientes referiu que gostaria de ter consulta de enfermagem pré-operatória caso fosse novamente submetido a uma cirurgia. O tempo médio de internamento teve uma redução pouco significativa de 7,09 dias para 6,73 dias (p=0,044). Cerca de 80,6% dos clientes passaram a realizar levante no dia da cirurgia na amostra ERASâ contrapondo-se a 3,2% de clientes na amostra pré-ERASâ. Relativamente ao retorno à autonomia na mobilização no período pós-operatório o tempo médio diminuiu de 3,48 para 2,00 dias (p<0,001). Conclusão: As informações transmitidas na consulta foram importantes para o cliente e para a sua participação nos cuidados pós-operatórios. Os níveis de satisfação com esta intervenção de enfermagem foram elevados e o cliente reconheceu a sua importância. O tempo médio de internamento não foi significativamente afetado pela consulta, no entanto, o retorno à autonomia na mobilização foi fortemente influenciado pela informação transmitida na consulta. Trata-se de uma intervenção centrada no cliente e por isso acrescentou valor aos cuidados prestados.
Introduction: This study starting point was the Enhanced Recovery After Surgeryâ (ERASâ) and consisted in planning, implementation of a preoperative nursing consultation and its evaluation. ERASâ is a perioperative care program that promotes patient preoperative optimization and reduce surgery stress for better health outcomes. This nursing consultation pretend to know better the patient and provide information for patient to get a more active role in its recovery. Objectives: Three main objectives were defined: (1) structure the consultation, (2) implement the consultation, and (3) evaluate the consultation. For this evaluation, specific objectives were listed to the main focuses of consultation evaluation: the information transmitted, the patient's experience with the surgical process; the patient's responsibility and participation in the surgical process; the patient´s satisfaction, the implications for the return of autonomy in mobilization and the implications for the length of stay. Method: This is a descriptive, longitudinal and quantitative study. The study design is divided into three parts: structuring, operationalization and consultation evaluation. To carry out this evaluation, two data collection instruments were used: a survey and a clinical results audit platform. Two non-probabilistic samples of patients were considered, one before the ERAS® program implementation and the other with the program implementation and comparing the results obtained according to the evaluation focuses. Data processing was performed through the Statistical Package for the Social Sciences® (SPSS®) and the results presented according to specific objectives. Results: Regarding the importance of the information transmitted, it was inferred that 59.1% of patients considered the information transmitted in the consultation was very important and for 34.4% was important. 74.2% of patients reported being very satisfied with the consultation and 19.4% satisfied. 100.0% of patients said they would like to have a preoperative nursing consultation if they had surgery again. The average length of stay was slightly reduced from 7.09 days to 6.73 days (p=0.044). Approximately 80.6% of patients started to perform the mobilization on the day of surgery in the ERASâ sample, as opposed to 3.2% of patients in the pre-ERASâ sample. Regarding the return to mobilization autonomy in the postoperative period, the mean time decreased from 3.48 to 2.00 days (p<0.001). Conclusion: The information conveyed in the consultation was important for the patients and for their participation in postoperative care. Satisfaction levels with this nursing intervention was high and the patient recognized its importance. The average length of stay was not much affected by the consultation, however, the return to autonomy in mobilization in days was strongly influenced by the information transmitted in the consultation. It is a patient centered intervention and therefore clearly added value to the care provided.
Introduction: This study starting point was the Enhanced Recovery After Surgeryâ (ERASâ) and consisted in planning, implementation of a preoperative nursing consultation and its evaluation. ERASâ is a perioperative care program that promotes patient preoperative optimization and reduce surgery stress for better health outcomes. This nursing consultation pretend to know better the patient and provide information for patient to get a more active role in its recovery. Objectives: Three main objectives were defined: (1) structure the consultation, (2) implement the consultation, and (3) evaluate the consultation. For this evaluation, specific objectives were listed to the main focuses of consultation evaluation: the information transmitted, the patient's experience with the surgical process; the patient's responsibility and participation in the surgical process; the patient´s satisfaction, the implications for the return of autonomy in mobilization and the implications for the length of stay. Method: This is a descriptive, longitudinal and quantitative study. The study design is divided into three parts: structuring, operationalization and consultation evaluation. To carry out this evaluation, two data collection instruments were used: a survey and a clinical results audit platform. Two non-probabilistic samples of patients were considered, one before the ERAS® program implementation and the other with the program implementation and comparing the results obtained according to the evaluation focuses. Data processing was performed through the Statistical Package for the Social Sciences® (SPSS®) and the results presented according to specific objectives. Results: Regarding the importance of the information transmitted, it was inferred that 59.1% of patients considered the information transmitted in the consultation was very important and for 34.4% was important. 74.2% of patients reported being very satisfied with the consultation and 19.4% satisfied. 100.0% of patients said they would like to have a preoperative nursing consultation if they had surgery again. The average length of stay was slightly reduced from 7.09 days to 6.73 days (p=0.044). Approximately 80.6% of patients started to perform the mobilization on the day of surgery in the ERASâ sample, as opposed to 3.2% of patients in the pre-ERASâ sample. Regarding the return to mobilization autonomy in the postoperative period, the mean time decreased from 3.48 to 2.00 days (p<0.001). Conclusion: The information conveyed in the consultation was important for the patients and for their participation in postoperative care. Satisfaction levels with this nursing intervention was high and the patient recognized its importance. The average length of stay was not much affected by the consultation, however, the return to autonomy in mobilization in days was strongly influenced by the information transmitted in the consultation. It is a patient centered intervention and therefore clearly added value to the care provided.
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Keywords
Cuidados de enfermagem Enfermagem perioperatória Cuidados centrados no cliente Enhanced Recovery After Surgery Nursing care Perioperative nursing Patient centered care