Gonçalves Rodrigo Costa, Nascimento José Eduardo de Aguilar, Rezio Marilia Arantes, Ferraz Eula Cristina Machado, Carvalho Rachel de
- Hospital Estadual de Urgências Governador Otávio Lage de Siqueira (HUGOL) - Goiânia - GO - Brasil.
- Centro Universitário de Várzea Grande - Várzea Grande - MT - Brasil.
Rev Col Bras Cir. 2025 May 12;52:e20253755. doi: 10.1590/0100-6991e-20253755-en. eCollection 2025.
INTRODUCTION: The preoperative fasting time does not, in practice, meet current recommendations for preoperative care. The implementation of clinical protocols for shortening preoperative fasting has faced numerous barriers. The present study aims to evaluate whether the creation, application and professional training to use a fasting abbreviation protocol, linked to the electronic medical record, is capable of managing and reducing preoperative fasting time. METHODS: The study was conducted in two public hospitals in Goiânia, Goiás, Brazil. The DMAIC project methodology (Problem Definition - Measurement - Analysis - Implementation and Control) was used. Initially, the preoperative fasting time was measured in both institutions and the possible root causes for its prolongation were analyzed. Based on this assessment, a fasting abbreviation protocol was developed, managed through the electronic medical record, and the preoperative fasting time was again measured. In parallel, training was carried out for the multidisciplinary team to apply the protocol. RESULTS: Preoperative fasting time was high and superior to current recommendations in both hospitals. The causes for this prolongation were identified and treated. There was a reduction in preoperative fasting time in both institutions (11.50 vs 8.17 hours, p:0.000) and (8.77 vs 8.07 hours, p:0.025). CONCLUSION: The construction of a protocol, considering the needs of each institution, its management through electronic health records and the use of multiple methodologies for training patient care teams make it possible to reduce the duration of preoperative fasting.
引言:在实际操作中,术前禁食时间并未达到当前术前护理的建议标准。缩短术前禁食时间的临床方案在实施过程中面临诸多障碍。本研究旨在评估创建、应用与电子病历相关联的禁食缩写方案并进行专业培训,是否能够管理和缩短术前禁食时间。 方法:该研究在巴西戈亚斯州戈亚尼亚市的两家公立医院开展。采用了DMAIC项目方法(问题定义 - 测量 - 分析 - 实施与控制)。最初,在两家机构测量术前禁食时间,并分析其延长的可能根本原因。基于此评估,制定了一个通过电子病历管理的禁食缩写方案,并再次测量术前禁食时间。同时,对多学科团队进行培训以应用该方案。 结果:两家医院的术前禁食时间均较长,且超过了当前建议标准。已识别并处理了导致延长的原因。两家机构的术前禁食时间均有所缩短(分别为11.50小时对8.17小时,p值:0.000)以及(8.77小时对8.07小时,p值:0.025)。 结论:根据各机构的需求构建方案,通过电子健康记录进行管理,并使用多种方法培训患者护理团队,能够缩短术前禁食时间。
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