Estratégias para mitigar o cancelamento de cirurgias eletivas em hospitais públicos: uma revisão integrativa

Abstract

Introduction: For a surgical procedure to occur, the Institution has invested in physical and human resources, although this is simple, all logistics are dispensed with for its performance. Surgical cancellation is seen as a common event among operating room professionals. However, this is an important event that must have the due attention of the entire Team involved, as many of the reasons for cancellations are potentially avoidable. It is necessary, therefore, to survey the main causes that lead to surgeries being canceled and that interventions are made aimed at solving these causes. Objective: The objective of this study was to construct a Clinical Guide to mitigate the cancellation of elective surgeries in public hospitals. Method: This is an integrative review carried out in six stages. The survey of articles was timeless, and was carried out through a search in the following databases: PubMed; Scientific Electronic Library Online (Scielo); Latin American and Caribbean Literature in Health Sciences (Lillacs); Virtual Health Library (VHL). Results: We found 214 publications that mentioned cancellations of surgeries and suspensions; 47 articles that had affinity with the theme were selected, 42 studies were excluded, resulting in 5 articles in RIL. Brazil had the highest number of publications, 4 studies (80%), with only 1 study from another country, Pakistan (20%); the databases that presented articles were SciELO Analytics 60%, and PubMed- National Library of Medicine 40%. The most frequent causes that emerged in the RIL studies were related to the patient, administration and logistics, and human resources; 4 articles (80%) brought suggestions to mitigate cancellations, namely: Implementation of a Periodic Control System 11.76%, Mapping of the Profile of Surgeries and Operative Teams 11.76%, Preoperative Follow-up and Quality Guidance 5.88%, Education Permanent and Follow-up performed by the Nurse 11.76%, Cancellation Rate Indicator 5.88%, Austere Measures to Reduce the Cancellation Rate 17.65%, Enable the Privilege for Surgical Scheduling to Teams with a Lower Cancellation Rate 5.88%, Surgical Risk Assessment Scales 5.88%, Nurse Governability 11.76%, Resource Planning 5.88%, Effective Communication between Professionals 5.88%; In view of the results, it was possible to establish a parallel between causes and emerging suggestions in the RIL, which resulted in the Clinical Guide. Conclusion: it was possible to build a guide with suggestions to mitigate surgery cancellations; it was observed that most of the causes raised are perfectly avoidable; To this end,it is necessary that the health institution is committed to correcting the causes which are feasible for adjustments, as most of them are organizational processes, thus not requiring financial support.