Elaboração de um protocolo de avaliação pré-operatória em hospital universitário na cidade de Manaus-Amazonas-Brasil

Abstract

Background: The patient with indication for an elective surgery, as opposed to an emergency surgery, can be stratified in order to decrease the waiting time, as well as prevent adverse events. Examination requests are routinely observed, which most often present results within normal limits and do not influence preoperative management. In this sense, it is common to find difficulties in following a protocol in the preoperative evaluation, since, in general, each professional draws up his own flowchart, causing a series of obstacles to the performance of surgical procedures. Objective (general): To develop a preoperative evaluation protocol for patients referred to elective surgery at the General Surgery Service of Hospital Universitário Getúlio Vargas (HUGV). Objectives (specific): 1. Conduct a situational analysis of the preoperative evaluation of elective general surgery developed at HUGV; 2. Promote discussion among the participating professionals to collect indications for the elaboration of the protocol; 3. Build a protocol for use in the preoperative evaluation based on the indications of the participating professionals, articulating their foundation with the scientific literature; 4. Develop a flowchart for the follow-up of the preoperative evaluation. Methods: This is a qualitative study using the action research methodology, using strategic planning tools such as the Likert Scale, SWOT Matrix and Brainstorming in order to emerge and substantiate the data. Such instruments helped in the survey of factual situations, positive and negative, in the development of this study in order to present proposals and solutions in the construction of the protocol. After data exploration, they were organized and analyzed through content analysis. Results: In the discussion of the data, primary categories emerged, such as: university hospital, multidisciplinary and regional aspects, which underlie the construction of criteria for preoperative evaluation and requests for complementary exams. In line with the professional indications, the elaboration of the protocol is structured based on the following elements: age, associated comorbidities, findings on physical examination and surgical size. The analyzed categories supported the construction of the criteria in the elaboration of the protocol. As a final result, in addition to the elaboration of the protocol, the importance of collaborative work is emphasized. The articulation of the multidisciplinary team in the construction of the work, based on the exchange of practices and knowledge, provided the experience with richness and ensured the validity of the flowcharts and the protocol as a final product.