Efetividade da telenfermagem pré-operatória em cirurgia ambulatorial: estudo quase experimental

Abstract

The objective of the study is to analyze the effectiveness of telenursing in the preoperative period of outpatient surgery to reduce nonconformities in preparation and surgical cancellation in patients aged 18 and over. This was a quasi-experimental study with a discontinuity and regression design, prepared with the support of the Revised Standards for Quality Improvement Reporting Excellence (SQUIRE®) tool, based on the analysis of nonconformity in preoperative preparation and surgical cancellation in intervention (with telenursing) and control (without telenursing) groups. The setting was the outpatient surgical center of a university institution that is part of the Unified Health System in the city of Rio de Janeiro. The study population consisted of 408 patients for outpatient surgery. Two institutional instruments were used for data collection. The tested intervention was implemented using the preoperative telenursing instrument the day before the anesthetic-surgical procedure in the intervention group. On the day of the anesthetic-surgical procedure, the surgical preparation assessment instruments were used in both groups. The data were organized in a spreadsheet in the Microsoft Excel® 2010 program, applying descriptive and comparative statistical analysis of the variables of interest. The patients were divided into control (n=203) and intervention group (n=205) groups. The results showed that in the intervention group there was a reduction in all types of nonconformities in surgical preparation, with a statistically significant difference in non-use of regular medications, pre-operative bath, use of adornments, failure to present complementary exams, prolonged fasting, use of dental prothesis and trichotomy with blade. The chance of nonconformities occurring in the intervention group was 8 times lower than in the control group, demonstrated by the odds ratio (OR) of 0.125 with confidence interval (CI) 0.072-0.215 and p-value <0.001. A reduction in cases of surgical cancellations was evident in the intervention group. The odds of surgical cancellation were 2.2 times lower for the intervention group compared to the control group with OR 0.458 (CI 0.254-0.828) and p-value 0.009. It is concluded that preoperative telenursing was effective in reducing nonconformities in the preparation and outpatient surgical cancellation, showing that it is an innovative practice with great contribution, and can provide improvement and quality in safe care for outpatient surgical patients.