Análisis de eventos adversos en los servicios de cirugía general y aparato digestivo. Estudio multicéntrico / Analysis of adverse events in general surgery: A multicenter study

Introducción: El conocimiento de los eventos adversos (EA) en los hospitales de agudos es un aspecto de especial relevancia en la seguridad del paciente. Su incidencia oscila entre un 3-17% y la cirugía se relaciona con la aparición de entre un 46-65% de todos los EA. Material y métodos: Se realiza un estudio observacional, descriptivo, retrospectivo y multicéntrico, con la participación de 31 hospitales de agudos españoles, para la determinación y análisis de los EA en los servicios de cirugía general. Resultados: La prevalencia de EA fue del 31,53%. Los tipos de EA más frecuentes fueron de tipo infeccioso (35%). Los pacientes con mayores grados de ASA, mayor complejidad y un tipo de ingreso urgente son factores asociados a la presencia de EA. A la mayoría de los pacientes se les atribuyó una categoría de daño F (daño temporal al paciente que requiera iniciar o prolongar la hospitalización) (58,42%). El 14,69% de los EA son considerados graves. El 34,22% de los EA se consideraron evitables. Conclusiones: La prevalencia de EA en los pacientes de cirugía general y del aparato digestivo (CGAD) es elevada. La mayor parte de los EA fueron de tipo infeccioso. El EA más frecuente fue la infección de herida o sitio quirúrgico. Los pacientes con mayores grados de ASA, mayor complejidad y un tipo de ingreso urgente son factores asociados a la presencia de EA. La mayoría de los EA detectados han supuesto un daño leve o moderado sobre los pacientes. Alrededor de un tercio de EA fueron evitables.(AU)

Introduction: Knowledge of adverse events (AE) in acute care hospitals is a particularly relevant aspect of patient safety. Its incidence ranges from 3% to 17%, and surgery is related to the occurrence of 46%-65% of all AE. Material and methods: An observational, descriptive, retrospective, multicenter study was conducted with the participation of 31 Spanish acute-care hospitals to determine and analyze AE in general surgery services. Results: The prevalence of AE was 31.53%. The most frequent types of AE were infectious (35%). Higher ASA grades, greater complexity and urgent-type admission are factors associated with the presence of AE. The majority of patients (58.42%) were attributed a category F event (temporary harm to the patient requiring initial or prolonged hospitalization); 14.69% of AE were considered severe, while 34.22% of AE were considered preventable. Conclusions: The prevalence of AE in General and GI Surgery (GGIS) patients is high. Most AE were infectious, and the most frequent AE was surgical site infection. Higher ASA grades, greater complexity and urgent-type admission are factors associated with the presence of AE. Most detected AE resulted in mild or moderate harm to the patients. About one-third of AE were preventable.(AU)

Augurio de nostálgica despedida: situación de enfermería bajo la teoría de Swanson / Nostalgic farewell omen: A nursing situation under the Swanson's theory

Introducción: Se narra una experiencia donde el sujeto de cuidado es una enfermera pionera de la disciplina de la Enfermería en Colombia, quien recibió atención de una egresada y una colega, en donde se vivencia cada momento de la atención y el crecimiento para la persona cuidada y cuidadoras. Objetivo: Comprender la importancia del cuidado de enfermería para el paciente y la enfermera a través de la narración y análisis de una situación de enfermería. Materiales y Métodos: El análisis se centra en los conceptos del metaparadigma, la visión del mundo de enfermería, los patrones de conocimiento y la teoría de rango medio de los cuidados de Kristen Swanson, los resultados se visibilizan en la relación enfermera-paciente, en el proceso de enfermería, en la consecución de la integridad, curación, sanación y en la vivencia de la nostálgica despedida de la paciente. Conclusión: La narración de enfermería es relevante para la teoría, práctica e investigación, porque a través de ella el profesional de enfermería da a conocer eventos que vivencian el quehacer diario y visibiliza los cuidados brindados en interacción con el otro, lo que permite aportar a la evolución del conocimiento de la disciplina.

Introduction: An experience is narrated in which the subject of care is a pioneer nurse in the discipline of nursing in Colombia who was cared for by a graduate and a colleague, and in which each moment of care and growth is experienced for the cared-for person and the caregivers. Objective: To understand the importance of nursing care to the patient and the nurse by narrating and analyzing a nursing situation. Materials and Methods: The analysis focuses on the concepts of metaparadigm, nursing worldview, patterns of knowing, and Kristen Swanson's middle-range theory of caring. The results are visible in the nurse-patient relationship, the nursing process, the achievement of wholeness and healing, and the experience of the patient's nostalgic farewell. Conclusion: Nursing narratives are relevant to theory, practice, and research because, through them, nursing professionals make known events that are experienced in daily work and make visible the care provided in interaction with others, contributing to the evolution of knowledge of the discipline.

Introdução: Narra-se uma experiência em que o sujeito do cuidado é uma enfermeira pioneira da disciplina de Enfermagem na Colômbia, que recebeu cuidados de uma graduada e de uma colega, onde se vivencia cada momento de cuidado e crescimento da pessoa cuidada e cuidadores. Objetivo: Compreender a importância do cuidado de enfermagem para o paciente e para o enfermeiro por meio da narração e análise de uma situação de enfermagem. Materiais e Métodos: A análise centra-se nos conceitos do metaparadigma, na visão de mundo da enfermagem, nos padrões de conhecimento e na teoria do cuidado de médio alcance de Kristen Swanson, os resultados são visíveis na relação enfermeiro-paciente, no processo de enfermagem, na concretização de integridade, cura e na vivência da nostálgica despedida do paciente. Conclusão: A narrativa de enfermagem é relevante para a teoria, a prática e a pesquisa, pois por meio dela o profissional de enfermagem dá a conhecer acontecimentos que vivencia o cotidiano do trabalho e torna visível o cuidado prestado na interação com o outro, o que permite contribuir para a evolução do conhecimento da disciplina.

Prevalencia de factores asociados al acceso venoso periférico difícil en población pediátrica en un hospital chileno / Prevalence of factors associated with difficult peripheral venous access in a paediatric population in a Chilean hospital / Prevalência de fatores associados ao acesso venoso periférico difícil em uma população pediátrica em um hospital chileno

INTRODUCCIÓN: La mitad de las instalaciones pediátricas de un catéter venoso periférico resultan ser en el contexto de un paciente, un acceso venoso difícil, definido como instalación de un catéter venoso periférico frustrado en la primera punción. Actualmente se utiliza como herramienta predictiva de acceso venoso difícil el DIVAscore, sin embargo, existen investigaciones que proponen nuevos factores asociados, surgiendo la necesidad de estudiarlos en profundidad. OBJETIVO: Identificar la prevalencia de factores asociados al acceso venoso difícil en pacientes pediátricos atendidos en el servicio de cirugía de un hospital en Chile, 2022. METODOLOGÍA: Investigación cuantitativa descriptiva transversal con muestreo intencionado. Fueron incluidos pacientes de edad entre 0a 14 años cumplidos con acceso venoso difícil. Para investigar estos antecedentes clínicos, se seleccionaron 5 de los más mencionados en la literatura: Obesidad, Diabetes, Anemia de Células Falciformes, Quimioterapia y Diálisis. Se utilizó una grilla de cotejo realizada Ad Hoc, los resultados fueron analizados mediante un software y el intervalo de confianza fue de 95%. RESULTADOS: La mediana de edad fue de 1 año, con un rango intercuartílico de 3. El antecedente evaluado más prevalente en los pacientes con acceso venoso difícil fue obesidad, presente en el 31% de la muestra y el segundo, fue anemia de células falciformes, presente en un 5%. CONCLUSIONES: Se evidenció una amplia diferencia entre las variables estudiadas, siendo obesidad la de mayor prevalencia; la investigación logró el propósito de aportar evidencia que ayude a la toma de decisiones para el cuidado del capital venoso del paciente.

INTRODUCTION: Half of the pediatric installations of a peripheral venous catheter turn out to be in the context of a patient, a difficult venous access, defined as the installation of a peripheral venous catheterfrustrated in the first puncture. Currently, the DIVAscore is used as a predictive tool for difficult venous access, however, there is research that proposes new associated factors, arising the need to study them in depth. AIM:To identify the prevalence of factors associated with difficult venous access in pediatric patients treated in the surgery service of a hospital in Chile, 2022. METHODOLOGY: Cross-sectional descriptive quantitative research with purposive sampling. Patients aged 0 to 14 years with difficult venous access were included. To investigate these clinical antecedents, 5 of the most mentioned in the literature were selected: Obesity, Diabetes, Sickle Cell Anemia, Chemotherapy and Dialysis. An Ad Hoc comparison grid was used, the results were analyzed using software and the confidence interval was 95%. RESULTS:The median age was 1 year, with an interquartile range of 3. The most prevalent antecedent evaluated in patients with difficult venous access was obesity, present in 31% of the sample and the second, was sickle cell anemia, present in 5%. CONCLUSIONS: A wide difference was evidenced between the variables studied, with obesity being the most prevalent; the research achieved the purpose of providing evidence that helps decision-making for the care of the patient's venous capital.

INTRODUÇÃO: Metade das instalações pediátricas de um cateter venoso periférico acaba por ser no contexto de um paciente, um acesso venoso difícil, definido como a instalação de um cateter venoso periférico frustrado na primeira punção. Atualmente, o DIVAscore é utilizado como ferramenta preditiva para acesso venoso difícil, entretanto, há pesquisas que propõem novos fatores associados, surgindo a necessidade de estudá-los a fundo. OBJETIVO: Identificar a prevalência de fatores associados à dificuldade de acesso venoso em pacientes pediátricos atendidos no serviço de cirurgia de um hospital no Chile, 2022. METODOLOGIA: Pesquisa quantitativa descritiva transversal com amostragem intencional. Foram incluídos pacientes de 0 a 14 anos com acesso venoso difícil.Para investigar esses antecedentes clínicos, foram selecionados 5 dos mais citados na literatura: Obesidade, Diabetes, Anemia Falciforme, Quimioterapia e Diálise. Uma grade de comparação Ad Hoc foi usada, os resultados foram analisados usando software eo intervalo de confiança foi de 95%.RESULTADOS: A mediana de idade foi de 1 ano, com intervalo interquartil de 3. O antecedente mais prevalente avaliado em pacientes com acesso venoso difícil foi a obesidade, presente em 31% da amostra e o segundo, foi aanemia falciforme, presente em 5 %. CONCLUSÕES: Evidenciou-se ampla diferença entre as variáveis estudadas, sendo a obesidade a mais prevalente; A pesquisa atingiu o objetivo de fornecer evidências que auxiliem na tomada de decisão para o cuidado com o capital venoso do paciente.

Características clínicas y resultados quirúrgicos de pacientes pediátricos intervenidos por cirugía robótica / Clinical characteristics and surgical outcomes of pediatric patients who underwent robotic surgery

INTRODUCCIÓN. La cirugía robótica se realiza gracias al sistema telemanipulado, alcanzando tareas repetitivas, precisas y mínimamente invasivas. En Ecuador inició en el año 2016, incluyendo este procedimiento a pediatría en el 2021. OBJETIVO. Describir las características clínicas y resultados quirúrgicos de pacientes pediátricos intervenidos por cirugía robótica. MATERIALES Y MÉTODOS. Estudio transversal analítico. Población de 278 y muestra de 40 datos de historias clínicas electrónicas de pacientes pediátricos intervenidos por cirugía robótica de agosto del 2021 a marzo del 2022 en el Hospital Carlos Andrade Marín. Criterios de inclusión: pacientes pediátricos intervenidos por cirugía robótica en el Hospital de Especialidades Carlos Andrade Marín. Criterios de exclusión: pacientes adultos, haber sido intervenidos quirúrgicamente por técnicas abiertas o laparoscópica. La información se obtuvo del sistema AS400; se creó una base de datos anonimizando a los pacientes. Se aplicó un análisis univariado y para determinar significancia estadística se utilizó la prueba de Chi-2. La información recolectada fue analizada en el programa estadístico International Business Machines Statistical Package for the Social Sciences. RESULTADOS: De los pacientes del estudio: 45,00% (18; 40) era adolescente. El 52,50% (21; 40) no presentó comorbilidades. 50,00% (20; 40) de las intervenciones fueron colecistectomía. 55% (22; 40) fué por diagnóstico prequirúrgico y posquirúrgico gastrointestinal y hepático. El 95,00% (38; 40) no presentó complicaciones. El 100% (40; 40) presentó sangrado G1. El 97,50% (39; 40) no presentó eventos, y el 72,5% (29; 40) no presentó dolor. El promedio de peso de los pacientes fue 41 kilogramos, con una media de 3 días de estancia hospitalaria, un promedio de 65 minutos de cirugía total y 15 minutos de docking, los cuales son estadísticamente significativos con una p= 0,001. CONCLUSIONES. Se registró las características clínicas y resultados quirúrgicos de pacientes pediátricos intervenidos por cirugía robótica. La cirugía robótica se aplicó con seguridad en pacientes pediátricos del Hospital Carlos Andrade Marín.

INTRODUCTION. Robotic surgery is performed thanks to the telemanipulated system, achieving repetitive, precise and minimally invasive tasks. In Ecuador it started in the Hospital de Especialidades Carlos Andrade Marín in 2016, including this procedure to pediatrics in 2021. OBJECTIVE. To describe the clinical characteristics and surgical outcomes of pediatric patients operated by robotic surgery. MATERIALS and METHODS. Analytical cross-sectional study. Population of 278 and sample of 40 data from electronic medical records of pediatric patients operated by robotic surgery from August 2021 to March 2022 at the Carlos Andrade Marin Hospital. Inclusion criteria: pediatric patients who underwent robotic surgery at the Hospital de Especialidades Carlos Andrade Marín. Exclusion criteria: adult patients, having undergone open or laparoscopic surgery. The information was obtained from the AS400 system; a database was created by anonymizing the patients. Univariate analysis was applied and the Chi-2 test was used to determine statistical significance. The information collected was analyzed in the statistical program International Business Machines Statistical Package for the Social Sciences. RESULTS: Of the patients in the study: 45,00% (18; 40) were adolescents. 52,50% (21; 40) had no comorbidities. 50,00% (20; 40) of the interventions were cholecystectomy. 55% (22; 40) were for preoperative and postoperative gastrointestinal and hepatic diagnosis. 95,00% (38; 40) had no complications. 100% (40; 40) presented G1 bleeding. 97.50% (39; 40) did not present events, and 72,5% (29; 40) did not present pain. The average weight of the patients was 41 kilograms, with a mean hospital stay of 3 days, an average of 65 minutes of total surgery and 15 minutes of docking, which are statistically significant with a p= 0,001. CONCLUSIONS. The clinical characteristics and surgical results of pediatric patients who underwent robotic surgery were recorded. Robotic surgery was safely applied in pediatric patients at the Carlos Andrade Marin Hospital.

Economic impact of periprosthetic hip fractures / Impacto económico de las fracturas periprotésicas de cadera

Introduction: Hip replacement is one of the most successful operations in orthopaedic surgery. Periprosthetic hip fractures (PPHF) have very serious consequences for the patient, and they also entail a very important economic impact on healthcare systems. The aim of the study was to provide the first detailed cost analysis of PPHF in a traumatology and orthopaedics service in a third level hospital in Spain. Methods: The study included all patients admitted between 2009 and 2019 with a diagnosis of “PPHF”. We assessed hospital stay cost, total cost of the operating theatre, cost of the implants used, analyses, consultations with other specialists, rehabilitation sessions, radiological tests, microbiology, blood transfusions and other surgical operations during the same admission. Results: 78 patients were included in the study, 49 women and 29 men, with a mean age of 78.74 years (R 45–92). 69 patients received surgical treatment, 75% had open reduction and internal fixation (ORIF), and 25% had revision surgery. The total cost was €1,139,650.17. The average cost was €14,610.90. Significantly higher costs were incurred for revision compared to ORIF treatments, admissions that lasted more than 30 days, and patients who required more than one operation during admission. The most costly factors were the hospital stay (46%), the cost of the surgery itself (35%), and the implants (24%). Conclusions: Revision arthroplasty versus ORIF treatment, admissions lasting more than 30 days, and patients requiring more than one operation on admission incurred significantly higher costs. The average cost, from a hospital perspective, generated by a PPHF was €14,610.90. The most costly factors were, in descending order, the hospital stay, the cost of the surgery itself, and the implants. It is necessary to establish protocols and updated therapeutic algorithms in the perioperative management of PPHF in order to reduce both morbidity rates and associated costs.(AU)

Introducción: La artroplastia de cadera es una de las operaciones con mejores resultados en cirugía ortopédica. Las fracturas periprotésicas de cadera (FPPC) tienen consecuencias muy graves para el paciente y además suponen un impacto económico muy importante para los sistemas sanitarios. El objetivo del estudio es realizar el primer análisis detallado de los costes de las FPPC en un Servicio de Cirugía Ortopédica y Traumatología en un hospital universitario de tercer nivel en España. Métodos: El estudio incluyó a todos los pacientes ingresados entre 2009 y 2019 con el diagnóstico de «FPPC». Se evaluaron el coste de la estancia hospitalaria, el coste total del quirófano, el coste de los implantes utilizados, los análisis de sangre, las consultas con otros especialistas, las sesiones de rehabilitación, las pruebas radiológicas, la microbiología, las transfusiones de sangre y otras intervenciones quirúrgicas durante el mismo ingreso. Resultados: Se incluyó a un total de 78 pacientes, 49 mujeres y 29 hombres, con una edad media de 78,74 años (R 45-92); 69 pacientes recibieron tratamiento quirúrgico, el 75% se sometió a reducción abierta y fijación interna (RAFI) y el 25% a revisión protésica. El coste total fue de 1.139.650,17 €. El coste medio fue de 14.610,90 €. Los costes fueron significativamente más elevados en la revisión protésica que en la RAFI, en los ingresos que duraron más de 30 días y en los pacientes que requirieron más de una intervención quirúrgica durante el ingreso. Los factores que más influyeron en el coste fueron la estancia hospitalaria (46%), el coste de la intervención quirúrgica (35%) y el de los implantes (24%). Conclusiones: La cirugía de revisión protésica frente a RAFI, los ingresos de más de 30 días y los pacientes que requirieron más de una intervención quirúrgica durante el ingreso supusieron costes significativamente mayores. El coste medio, desde el punto de vista hospitalario, generado por una FPPC fue de 14.610,90 €.(AU)

[Artículo traducido] Impacto económico de las fracturas periprotésicas de cadera / Economic impact of periprosthetic hip fractures

Introduction: Hip replacement is one of the most successful operations in orthopaedic surgery. Periprosthetic hip fractures (PPHF) have very serious consequences for the patient, and they also entail a very important economic impact on healthcare systems. The aim of the study was to provide the first detailed cost analysis of PPHF in a traumatology and orthopaedics service in a third level hospital in Spain. Methods: The study included all patients admitted between 2009 and 2019 with a diagnosis of “PPHF”. We assessed hospital stay cost, total cost of the operating theatre, cost of the implants used, analyses, consultations with other specialists, rehabilitation sessions, radiological tests, microbiology, blood transfusions and other surgical operations during the same admission. Results: 78 patients were included in the study, 49 women and 29 men, with a mean age of 78.74 years (R 45–92). 69 patients received surgical treatment, 75% had open reduction and internal fixation (ORIF), and 25% had revision surgery. The total cost was €1,139,650.17. The average cost was €14,610.90. Significantly higher costs were incurred for revision compared to ORIF treatments, admissions that lasted more than 30 days, and patients who required more than one operation during admission. The most costly factors were the hospital stay (46%), the cost of the surgery itself (35%), and the implants (24%). Conclusions: Revision arthroplasty versus ORIF treatment, admissions lasting more than 30 days, and patients requiring more than one operation on admission incurred significantly higher costs. The average cost, from a hospital perspective, generated by a PPHF was €14,610.90. The most costly factors were, in descending order, the hospital stay, the cost of the surgery itself, and the implants. It is necessary to establish protocols and updated therapeutic algorithms in the perioperative management of PPHF in order to reduce both morbidity rates and associated costs.(AU)

Introducción: La artroplastia de cadera es una de las operaciones con mejores resultados en cirugía ortopédica. Las fracturas periprotésicas de cadera (FPPC) tienen consecuencias muy graves para el paciente y además suponen un impacto económico muy importante para los sistemas sanitarios. El objetivo del estudio es realizar el primer análisis detallado de los costes de las FPPC en un Servicio de Cirugía Ortopédica y Traumatología en un hospital universitario de tercer nivel en España. Métodos: El estudio incluyó a todos los pacientes ingresados entre 2009 y 2019 con el diagnóstico de «FPPC». Se evaluaron el coste de la estancia hospitalaria, el coste total del quirófano, el coste de los implantes utilizados, los análisis de sangre, las consultas con otros especialistas, las sesiones de rehabilitación, las pruebas radiológicas, la microbiología, las transfusiones de sangre y otras intervenciones quirúrgicas durante el mismo ingreso. Resultados: Se incluyó a un total de 78 pacientes, 49 mujeres y 29 hombres, con una edad media de 78,74 años (R 45-92); 69 pacientes recibieron tratamiento quirúrgico, el 75% se sometió a reducción abierta y fijación interna (RAFI) y el 25% a revisión protésica. El coste total fue de 1.139.650,17 €. El coste medio fue de 14.610,90 €. Los costes fueron significativamente más elevados en la revisión protésica que en la RAFI, en los ingresos que duraron más de 30 días y en los pacientes que requirieron más de una intervención quirúrgica durante el ingreso. Los factores que más influyeron en el coste fueron la estancia hospitalaria (46%), el coste de la intervención quirúrgica (35%) y el de los implantes (24%). Conclusiones: La cirugía de revisión protésica frente a RAFI, los ingresos de más de 30 días y los pacientes que requirieron más de una intervención quirúrgica durante el ingreso supusieron costes significativamente mayores. El coste medio, desde el punto de vista hospitalario, generado por una FPPC fue de 14.610,90 €.(AU)

Comportamentos destrutivos entre profissionais em centro cirúrgico: revisão integrativa da literatura / Inadequate behavior manifested by professionals in the surgical center: integrative literature review / Comportamiento inadecuado manifestado por profesionales del centro quirúrgico: revisión integrativa de la literatura

Objetivo: Identificar as evidências sobre comportamentos destrutivos manifestados ou presenciados por profissionais em centro cirúrgico. Métodos: Revisão integrativa da literatura, realizada nas bases de dados Literatura Latino-Americana em Ciências da Saúde, Medical Literature Analysis and Retrieval System Online e Base de Dados da Enfermagem, em novembro e dezembro de 2019, aos pares, sem recorte temporal, em português, inglês e espanhol. Na busca, foram utilizados termos e descritores, combinados entre si por meio dos operadores booleanos AND e OR. Resultados: Foram localizados 230 artigos. Após eliminação de duplicidades, aplicação dos critérios de inclusão e exclusão, e leitura, obteve-se amostra de 10. Da análise dos estudos, emergiram três categorias temáticas: Categoria 1 ­ Comportamentos destrutivos; Categoria 2 ­ Repercussões dos comportamentos destrutivos; Categoria 3 ­ Dispositivos para minimizar ambientes hostis. Conclusão: os comportamentos destrutivos têm repercussões organizacionais, laborais e pessoais, caracterizando um desrespeito sistêmico que causa danos tanto aos profissionais como aos pacientes. (AU)

Objective: Identify evidence of inadequate behavior manifested by professionals in the surgical center. Methods: An integrative literature review, carried out in the Latin American Literature in Health Sciences, Medical Literature Analysis and Retrieval System Online and Nursing Database databases, in November and December 2019, in pairs, without time frame, in Portuguese, English and Spanish. In the search, terms and descriptors were used, combined with each other through the Boolean operators AND and OR. R. Results: 230 articles were located. After elimination of duplicates, application of inclusion and exclusion criteria, and reading, a sample of 10 was obtained. From the analysis of the studies, three thematic categories emerged: Category 1 ­ destructive behavior; Category 2 ­ repercussions of inadequate behavior; Category 3 ­ devices for minimizing hostile environments. Conclusion: Inadequate behavior has organizational, labor and personal repercussions, and characterizes systemic disrespect that causes damage to both professionals and patients. (AU)

Objetivo: Identificar evidencias de conducta inadecuada manifestada por profesionales en el centro quirúrgico. Métodos: Revisión integradora de la literatura, realizada en las bases de datos de Literatura Latinoamericana en Ciencias de la Salud, Sistema de Análisis y Recuperación de Literatura Médica en Línea y Base de Datos de Enfermería, en noviembre y diciembre de 2019, en pares, sin marco temporal, en portugués, inglés y español. En la búsqueda se utilizaron términos y descriptores, combinados entre sí mediante los operadores booleanos AND y OR. R. Resultados: Se localizaron 230 artículos. Luego de eliminación de duplicados, aplicación de criterios de inclusión y exclusión y lectura, se obtuvo una muestra de 10. Del análisis de los estudios surgieron tres categorías temáticas: Categoría 1 - comportamiento destructivo; Categoría 2: repercusiones de un comportamiento inadecuado; Categoría 3: dispositivos para minimizar entornos hostiles. Conclusión: La conducta inadecuada tiene repercusiones organizativas, laborales y personales, y caracteriza la falta de respeto sistémica que causa daño tanto a los profesionales como a los pacientes. (AU)

Association between delta anion gap and hospital mortality for patients in cardiothoracic surgery recovery unit: a retrospective cohort study.

BACKGROUNDS: High level of anion gap (AG) was associated with organic acidosis. This study aimed to explore the relationship between delta AG (ΔAG = AGmax - AGmin) during first 3 days after intensive care unit (ICU) admission and hospital mortality for patients admitted in the cardiothoracic surgery recovery unit (CSRU). METHODS: In this retrospective cohort study, we identified patients from the open access database called Multiparameter Intelligent Monitoring in Intensive Care III (MIMIC III). A logistic regression model was established to predict hospital mortality by adjusting confounding factors using a stepwise backward elimination method. We conducted receiver operating characteristic (ROC) curves to compare the diagnostic performance of acid-base variables. Cox regression model and Kaplan Meier curve were applied to predict patients' 90-day overall survival (OS). RESULTS: A total of 2,860 patients were identified. ΔAG was an independent predictive factor of hospital mortality (OR = 1.24 per 1 mEq/L increase, 95% CI: 1.11-1.39, p < 0.001). The area under curve (AUC) values of ΔAG suggested a good diagnostic accuracy (AUC = 0.769). We established the following formula to estimate patients' hospital mortality: Logit(P) = - 15.69 + 0.21ΔAG + 0.13age-0.21BE + 2.69AKF. After calculating Youden index, patients with ΔAG ≥ 7 was considered at high risk (OR = 4.23, 95% CI: 1.22-14.63, p = 0.023). Kaplan Meier curve demonstrated that patients with ΔAG ≥ 7 had a poorer 90-day OS (Adjusted HR = 3.20, 95% CI: 1.81-5.65, p < 0.001). CONCLUSION: ΔAG is a prognostic factor of hospital mortality and 90-day OS. More prospective studies are needed to verify and update our findings.

Avaliação de indicadores de qualidade na gestão do centro cirúrgico de um hospital terciário / Evaluation of quality indicators in the management of an operating room at a tertiary-level hospital

Introdução: Por se tratar de um setor complexo e que compreende grande parte dos custos de um hospital, o centro cirúrgico demanda uma contínua avaliação de suas atividades, com o objetivo de propiciar uma melhora da sua eficiência e da segurança dos pacientes. Uma estratégia interessante para se realizar tal avaliação é a utilização de um conjunto de indicadores de qualidade preestabelecidos, dividindo os atributos do serviço em estrutura, processos e resultados. Para que isso seja possível, é necessário que o serviço analisado possua uma fonte de dados bem estruturada, tendo o Núcleo Interno de Regulação um papel importante nesse processo. Objetivo: Este estudo teve como objetivo a análise de índices de gestão do centro cirúrgico de um hospital terciário especializado em cirurgias eletivas através da mensuração de dados referentes a indicadores de qualidade. Metodologia: Trata-se de um estudo observacional descritivo feito de forma retrospectiva em um hospital escola público do interior do estado de São Paulo. Foram mensurados 18 indicadores referentes ao período de 01/06/2019 a 31/12/2019, a partir de consultas a diferentes setores administrativos do local. Os resultados passaram por uma análise estatística descritiva ao final da coleta de dados. Resultados: Os principais resultados encontrados foram: taxa de cumprimento da agenda cirúrgica de 95,8%, taxa de cancelamento de 4,1%, taxa de ocupação de 47,9%, turnover de 23,1 minutos, tempo médio de atraso no início das cirurgias de 32,8 minutos, tempo de permanência na sala de recuperação pós-anestésica de 37,4 minutos, taxa de absenteísmo dos profissionais de 8,94% e as taxas de infecção do sítio cirúrgico, de mortalidade operatória e de acidente de trabalho foram todas 0%. Conclusões: Apesar da alta taxa de cumprimento da agenda cirúrgica, a taxa de ocupação se encontrou aquém do ideal, sugerindo que o agendamento das cirurgias pode ser melhorado. Além disso, demonstrou-se que a estratégia de "cirurgias reservas" adotada no hospital auxilia no cumprimento da meta de cirurgias programadas e no aumento da taxa de ocupação (AU)

Introduction: As a complex sector that results in a large part of the costs in a hospital, the operating room demands a continuous evaluation of its activities, with the objective of providing an improvement in its efficiency and in patient safety. An interesting strategy to carry out such an evaluation is using a set of pre-established quality indicators, by the division of the service's attributes into structure, processes and results, which can provide a broad perspective of the activities developed and facilitate decision-making by the hospital manager. In this analysis process, it is necessary that the service has a well-structured data source, where the Internal Regulation Center plays an important role. Objective: The objective of this study was to analyze, through the measurement of data related to quality indicators, the management indexes of the operating room of a tertiary-level hospital specialized in elective surgeries. Methodology: This is a descriptive observational study that was conducted retrospectively at a public teaching hospital. In this research, 18 indicators, related to the period from 06/01/2019 to 12/31/2019, were measured based on consultations to different administrative sectors of the hospital. The results went through a descriptive statistical analysis at the end of data collection. Results:The main results found were as follows: the fulfillment rate of the surgical schedule was 95.8%, the cancellation rate was 4.1%, the occupancy rate was 47.9%, the turnover time was 23.1 minutes, the mean delay time in the start of surgeries was 32.8 minutes, length of stay in the post-anesthesia care unit was 37.4 minutes, the professionals' absenteeism rate was 8.94%, and the rates of surgical site infection, operative mortality and work accident were all 0%. Conclusions: Despite the high fulfillment rate of the surgical schedule, the occupancy rate was below the ideal, suggesting that scheduling of surgeries can be improved. In addition, it was shown that the "reserve surgeries" strategy adopted at the hospital helped to reach the goal of scheduled surgeries and to increase the occupancy rate (AU)

Evaluación de los Comportamientos de Cuidado Humano de las enfermeras: perspectiva de personas adultas hospitalizadas / Evaluation of Caring Behaviours by nurses: A perspective by hospitalized adult persons

Objetivo: evaluar los comportamientos del cuidado humano brindado por profesionales de Enfermería desde la perspectiva de personas adultas atendidas en un hospital de especialidades en México. Método: estudio descriptivo transversal realizado entre septiembre y diciembre de 2020. Se efectuó muestreo por conveniencia en los servicios de cirugía, traumatología y medicina interna. Se midieron variables sociodemográficas, clínicas y la escala Caring Behaviors Assessment en su versión validada al español. Esta incluye 63 comportamientos de cuidado humano brindado por los enfermeros medidos con escala Likert (de 1 nunca a 5 siempre). Se llevó a cabo estadística descriptiva y bivariante. Resultados: participaron 103 personas con una media de edad de 45,3 años. El 50,5% era hombre y el 72,8% tenía escolarización secundaria o menor. Evaluaron que las enfermeras mostraban comportamientos de cuidado humano casi siempre o siempre (X= 4,28; DE 0,46) en la escala global. La subescala de Asistencia a las Necesidades Humanas obtuvo el mayor promedio (X= 4,73; DE= 0,46) mientras que la de Enseñanza/Aprendizaje obtuvo el más bajo (X= 3,54; DE= 1,13). Trato respetuoso, individualizado y manejo de equipos fueron los comportamientos de cuidado mejor evaluados. Las visitas en los traslados, el hablar sobre la vida fuera del hospital, la planificación de metas de salud, el tacto para el consuelo y la consideración de necesidades espirituales, los peor evaluados. Conclusiones: los comportamientos de cuidado mejor evaluados fueron los relacionados con las habilidades instrumentales de los enfermeros y el respeto al paciente. El contacto físico, la conversación con el paciente y la consideración de las necesidades espirituales fueron algunos de los comportamientos pendientes de desarrollar.(AU)

Objective: to evaluate the caring behaviour provided by Nursing professionals, from the perspective of adult persons managed at a Tertiary Care Hospital in Mexico. Method: a descriptive cross-sectional study conducted between September and December 2020. There was convenience sampling at the Surgery, Orthopaedic Surgery and Internal Medicine Departments. Sociodemographic and clinical variables were measured. The Caring Behaviours Assessment scale was used in its version validated in Spanish, which includes 62 caring behaviours provided by nurses and measured with the Likert scale (from 1: never to 5: always). Descriptive and bivariate statistic was applied. Results: the study included 103 persons with 45.3 years as mean age; 50,5% were male and 72.8% had secondary or lower schooling. The evaluation confirmed that nurses showed caring behaviours almost always or always (X= 4.28; SD 0.46) in the overall scale. The Assistance to Human Needs subscale obtained the highest average (X= 4.73; SD= 0.46) while Teaching/Learning obtained the lowest (X= 3.54; SD= 1.13). Respectful and individualized treatment, and equipment operation were the best scored caring behaviours, while the ones with worse scores were visits during transfers, discussing life outside hospital, planning health goals, tact for comforting, and the consideration of spiritual needs. Conclusions: the caring behaviours better scored were those associated with the instrumental skills of nurses and respect to patients. Physical contact, conversation with the patient, and consideration of spiritual needs were some of the behaviours still pending development.(AU)

¿Hay diferencias importantes en la comorbilidad entre los pacientes ingresados en servicios quirúrgicos y los ingresados en servicios médicos? / Are there important differences in comorbidity between surgical and medical inpatients?

Antecedentes y objetivo: El desarrollo científico y tecnológico está cambiando la práctica médica y transformando los hospitales, seleccionando los pacientes que permanecen hospitalizados, los cuales están aumentando su edad y comorbilidad. Son cada vez más complejos médicamente y con menos diferencias clínicas entre los pacientes médicos y quirúrgicos, lo que puede implicar cambios organizativos y asistenciales hospitalarios. Nuestro objetivo es valorar las diferencias en la edad y comorbilidad existentes entre los pacientes hospitalizados en las áreas médica y quirúrgica. Materiales y métodos: Estudio descriptivo observacional retrospectivo que ha incluido a los pacientes de edad ≥16 años dados de alta durante el año 2019 de todos los servicios médicos y quirúrgicos, excluidos Obstetricia y Cuidados Intensivos. Los datos se obtuvieron del CMBD del hospital y fueron analizados mediante análisis univariante. Resultados: Se incluyeron 31.264 pacientes, 16.397 del área médica y 14.867 del área quirúrgica. Los del área quirúrgica son 8 años más jóvenes (62,69 años [IC 95% 62,4-62,98]), con mayor proporción de mujeres (OR 1,12 [IC 95% 1,07-1,17]) y menos ingresos urgentes (OR 0,11 [IC 95% 0,10-0,12]). En las variables relacionadas con la carga de comorbilidad los resultados entre ambos grupos de pacientes son similares en todas ellas y sin diferencias significativas. Conclusiones: Los enfermos del área quirúrgica tienen una alta carga de comorbilidad médica, similar a los del área médica. Conocer este dato es importante para cirujanos y anestesistas y abre la puerta para planear alternativas a la organización hospitalaria actual.(AU)

Background and objective: Scientific and technological advances are changing medical practice and transforming hospitals, and both the age and comorbidities of hospitalized patients are rapidly increasing. The increasing complexity of these patients and the scant clinical differences between medical and surgical inpatients calls for changes in the organization and delivery of in-hospital care.Our objective has been to assess differences in age and comorbidity between surgical and medical inpatients. Materials and methods: Retrospective, observational, descriptive study in patients aged ≥ 16 years discharged from all medical and surgical services during 2019, except for obstetrics and intensive care. All data were obtained from the hospital's minimum basic data set and analyzed using univariate analysis. Results: The study included 31,264 patients: 16,397 from the medical area and 14,867 from the surgical area. Those in the surgical area were 8 years younger (62.69 years [95% CI 62.4-62.98]), with a slightly higher proportion of women (OR 1.12 [95% CI 1.07-1.17]) compared to the medical area, and fewer non-scheduled admissions (OR 0.11 [95% CI 0.10-0.12]). There were no significant differences in comorbidity burden between study groups. Conclusions: Patients in the surgical area have a high burden of medical comorbidity, similar to those in the medical area. This information is important for surgeons and anesthetists, and should compel hospitals to change the current organizational model.(AU)

[Management of Chest Drains after Elective, Thoracoscopic, Anatomical Lung Resections. A Survey in Thoracic Surgical Departments in Germany]. / Management von Thoraxdrainagen nach elektiven, thorakoskopischen, anatomischen Lungenresektionen an thoraxchirurgischen Zentren in Deutschland . Eine Umfrage über die Deutsche Gesellschaft für Thoraxchirurgie (DGT).

INTRODUCTION: The increasing use of minimally invasive techniques along with the introduction of the "Enhanced Recovery After Surgery" (ERAS) guidelines have reduced the perioperative risk of anatomic lung resections. However, the prolonged postoperative air leak still remains one of the major postoperative issues. The purpose of this survey was to evaluate the perioperative management of chest drains and the current clinical practice in treating prolonged air leaks after elective, thoracoscopic, anatomic lung resections in Germany. METHODS: We performed a survey among the thoracic surgical units, which are listed in the Database of the German Thoracic Society (n = 160). Based on the number of resections annually, the centres were divided into high- and low-volume and the results were presented accordingly. RESULTS: The response rate was 35.6%. Most of the units routinely place a single, 24 Ch. chest drain, which they connect to a digital system on suction. 42.1% of the thoracic units treat a postoperative air leak after the 7th postoperative day. The majority of the surgeons either reduce the suction or use other conservative measures to deal with the air leak. There is no significant difference in the drain management between high- and low-volume centres. CONCLUSION: The postoperative hospital stay after an uncomplicated lobectomy has come down to a few days whereas the lower limit of the length of stay has been reduced to 2 days. Nevertheless, 80% of the German thoracic surgeons define a postoperative air leak as prolonged, when it lasts beyond the 5th postoperative day and 65% deal with it only after the 5th postoperative day. The available evidence on this field is limited. New prospective clinical studies are required in order to improve the management of this common complication.

A educação e formação dos enfermeiros do bloco operatório durante a pandemia por COVID-19: uma scoping review / The education and training of operating room nurse's during covid-19 pandemic: A scoping review

A 11 de março de 2020 a Organização Mundial de Saúde declara a situação de pandemia por COVID-19. Neste contexto, com o número crescente de novos casos e o risco elevado de transmissão do vírus SARS-CoV-2, os profissionais de saúde foram confrontados, diariamente, com casos suspeitos ou confirmados de infeção e novas exigências na prestação de cuidados para mitigar a propagação da doença, num ambiente de incerteza e com necessidade de atualização constante do conhecimento. Por isso, é fundamental a aquisição de conhecimentos e competências pelos profissionais, por forma a melhor cuidarem dos doentes e protegerem-se de potencial contágio. A pandemia colocou desafios aos enfermeiros do bloco operatório no sentido de adequarem procedimentos e protocolos a esta nova realidade. O presente estudo teve como objetivo analisar o conhecimento sobre as intervenções educativas ou formativas, a que os enfermeiros do bloco operatório tiveram acesso, na fase de pandemia, por forma a prestarem cuidados com mestria e segurança. Trata-se de um estudo de revisão, uma scoping review, sustentada na metodologia de Joanna Briggs Institute e que obedece aos critérios de elegibilidade com base na População, Conceito e Contexto. Elaborada a frase booleana e realizada a pesquisa nas seguintes bases de dados: ACADEMIC SEARCH COMPLETE, CINAHL COMPLETE, MEDLINE WITH FULL TEXT, MEDICLATINA, ERIC, EMBASE (SCOPUS), WEB of SCIENCE, RCAAP e RENATES. Foram incluídos oito estudos, na sua maioria revisões narrativas com relato de experiências e revisão de recomendações, e apenas um estudo comparativo, com identificação da intervenção educativa e sua avaliação. Os resultados apontam para a importância da formação e educação, particularmente através de treino e simulação, com especial foco nos equipamentos de proteção individual, procedimentos geradores de aerossóis e gestão do contexto perioperatório. A análise realizada demonstra a relevância das intervenções educativas e formativas na capacitação dos enfermeiros para responderem às exigências da pandemia COVID-19, e deixa clara a necessidade de se desenvolverem estudos que concretizem planos de intervenção teoricamente fundamentados, com avaliação da sua eficácia, no sentido de produzir evidência que permita a translação da investigação para a prática clínica

On the 11th of March 2020, the World Health Organization declared a pandemic situation by COVID-19. In this context, with the increasing number of new cases and the high risk of transmission of the SARS-CoV-2 virus, health professionals were confronted with suspected or confirmed cases of infection, and with new requirements in the provision of care to mitigate the spread of the disease. This occurred during an environment of uncertainty and continuous flow of information. With this, it is essential that professionals develop knowledge to better care for patients and protect themselves from potential contagion. The pandemic posed challenges to nurses in the operating room as it was necessary to adapt procedures and protocols to this new reality. The present study aimed to analyze the knowledge regarding educational or formative interventions that the nurses in the operating room had access to during the pandemic situation. It corresponds to a scoping review based on the methodology of Joanna Briggs Institute and that follows the eligibility criteria based on Population, Concept and Context. The Boolean phrase was elaborated, and the research was carried out in the following databases: ACADEMIC SEARCH COMPLETE, CINAHL COMPLETE, MEDLINE WITH FULL TEXT, MEDICLATINA, ERIC, EMBASE (SCOPUS), WEB of SCIENCE, RCAAP and RENATES. Eight studies were included, including narrative reviews, detailing the experience and review of recommendations, and one comparative study, that identifies and evaluates the educational intervention. The results bring awareness to the importance of education, particularly through training and simulation, with special focus on personal protective equipment, aerosol-generating procedures, and perioperative context management. The analysis demonstrates the importance of educational and formative interventions in the training of nurses to respond to the demands of the COVID-19 pandemic. Additionally, it makes clear the need to develop studies that implement theoretically grounded intervention plans, with evaluation of their effectiveness, to produce evidence that allows implementing research into clinical practice.

Comparison of surgical outcomes for colostomy closure performed by acute care surgeons versus a dedicated colorectal surgery service.

BACKGROUND: Despite colostomy closure being a common procedure, it remains highly morbid. Previous literature suggests that complication rates, including surgical site infections, intra-abdominal abscess, and anastomotic failures, reach as high as 50%. With the creation of a dedicated colorectal service, colostomy reversals have been largely migrated from the acute care surgery services. This study analyzes the differences in outcomes in colostomy closures performed between colorectal surgeons and acute care surgeons. METHODS: We retrospectively analyzed our experience with 127 colostomy closures performed in our hospital system by acute care surgeons and colorectal surgeons from 2016 through 2020. Demographic data, operative data, and outcomes such as abscess formation, anastomotic leak, and readmission were analyzed. Multivariate regression analysis was performed for intraabdominal abscesses and anastomotic leaks. RESULTS: In total, 71 colostomy closures were performed by colorectal surgeons (56%) and 56 by acute care surgeons (43%). The majority of colostomy reversals were after Hartmann's procedure for perforated diverticulitis. No differences in demographics were identified, except for a shorter interval to closure in the acute care surgeons group (10.0 vs 7.2 months; P = .049). Two (3.6%) acute care surgeon patients required colorectal surgeon consultation during the definitive repair. Regression analysis identified body mass index (odds ratio 2.43; P = .001), male gender (odds ratio -2.39; P = .18), and colorectal surgeons (odds ratio -2.28; P = .025) as significant risk factors for anastomotic leak. CONCLUSION: Analysis of the current series identified female gender and increased body mass index as higher risk, while procedures performed by colorectal surgeons were at decreased risk for anastomotic leak. Our study identified colostomy reversals performed by a dedicated colorectal service decreased the rate of anastomotic leak.

Acreditación de unidades quirúrgicas especializadas en cirugía general y aparato digestivo: un paso de la Asociación Española de Cirujanos para mejorar la calidad asistencial y la formación subespecializada tipo fellowship / Accreditation of specialized surgical units in general and digestive surgery: A step forward by the AEC for quality improvement and subspecialized Fellowship training

En la práctica clínica asistencial la existencia de determinadas «unidades quirúrgicas especializadas», que se distinguen por su estructura, dotación de recursos humanos, organización, docencia e investigación ya son una realidad en la mayoría de los hospitales en España. Igualmente, están ya en marcha programas de formación especializada tipo fellowship, financiados de forma no estatal, en algunas de las áreas reconocidas de unidades quirúrgicas especializadas dentro de la cirugía general y aparato digestivo, algunas de ellas avaladas por la AEC. No obstante, hasta el momento no existía un modelo para dotarlo de reconocimiento y acreditación. La AEC ha diseñado una normativa para la acreditación de unidades quirúrgicas especializadas en cirugía general y aparato digestivo, que servirá de base también para definir la formación en estas áreas. El proceso de acreditación, y con ello de mejora de la calidad, engloba aspectos de calidad estructural, calidad de proceso y calidad de resultados(AU)

At present, in daily practice, the Departments of Surgery in most hospitals in Spain are organized into “Specialized Surgical Units”, including specific structure, human resources, organization, teaching and research in the different subspecialties included in General and Digestive Surgery (GDS). Furthermore, there are also several specialized “fellowship-like”, training programs in the different subspecialties already working in some of these “Specialized Surgical Units”, although not officially financed. However, until now there was no model for accreditation or recognition of these Units or fellowship programs. The AEC has designed a regulation for the accreditation of Specialized Surgical Units in GDS, that will also serve as a model to define subspecialty training in these areas. The accreditation process, and with it, the process of quality improvement, includes different quality indicators, including unit structure, process quality, and result indicators.(AU)

Avaliação de indicadores de qualidade na gestão do centro cirúrgico de um hospital terciário / Evaluation of quality indicators in the management of an operating room at a tertiary-level hospital

RESUMO: Introdução: Por se tratar de um setor complexo e que compreende grande parte dos custos de um hospital, o centro cirúrgico demanda uma contínua avaliação de suas atividades, com o objetivo de propiciar uma melhora da sua eficiência e da segurança dos pacientes. Uma estratégia interessante para se realizar tal avaliação é a utilização de um conjunto de indicadores de qualidade preestabelecidos, dividindo os atributos do serviço em estrutura, processos e resultados. Para que isso seja possível, é necessário que o serviço analisado possua uma fonte de dados bem estruturada, tendo o Núcleo Interno de Regulação um papel importante nesse processo. Objetivo: Este estudo teve como objetivo a análise de índices de gestão do centro cirúrgico de um hospital terciário especializado em cirurgias eletivas através da mensuração de dados referentes a indicadores de qualidade. Metodologia: Trata-se de um estudo observacional descritivo feito de forma retrospectiva em um hospital escola público do interior do estado de São Paulo. Foram mensurados 18 indicadores referentes ao período de 01/06/2019 a 31/12/2019, a partir de consultas a diferentes setores administrativos do local. Os resultados passaram por uma análise estatística descritiva ao final da coleta de dados. Resultados: Os principais resultados encontrados foram: taxa de cumprimento da agenda cirúrgica de 95,8%, taxa de cancelamento de 4,1%, taxa de ocupação de 47,9%, turnover de 23,1 minutos, tempo médio de atraso no início das cirurgias de 32,8 minutos, tempo de permanência na sala de recuperação pós-anestésica de 37,4 minutos, taxa de absenteísmo dos profissionais de 8,94% e as taxas de infecção do sítio cirúrgico, de mortalidade operatória e de acidente de trabalho foram todas 0%. Conclusões: Apesar da alta taxa de cumprimento da agenda cirúrgica, a taxa de ocupação se encontrou aquém do ideal, sugerindo que o agendamento das cirurgias pode ser melhorado. Além disso, demonstrou-se que a estratégia de "cirurgias reservas" adotada no hospital auxilia no cumprimento da meta de cirurgias programadas e no aumento da taxa de ocupação. (AU)

ABSTRACT: Introduction: As a complex sector that results in a large part of the costs in a hospital, the operating room demands a continuous evaluation of its activities, with the objective of providing an improvement in its efficiency and in patient safety. An interesting strategy to carry out such an evaluation is using a set of pre-established quality indicators, by the division of the service's attributes into structure, processes and results, which can provide a broad perspective of the activities developed and facilitate decision-making by the hospital manager. In this analysis process, it is necessary that the service has a well-structured data source, where the Internal Regulation Center plays an important role. Objective: The objective of this study was to analyze, through the measurement of data related to quality indicators, the management indexes of the operating room of a tertiary-level hospital specialized in elective surgeries. Methodology: This is a descriptive observational study that was conducted retrospectively at a public teaching hospital. In this research, 18 indicators, related to the period from 06/01/2019 to 12/31/2019, were measured based on consultations to different administrative sectors of the hospital. The results went through a descriptive statistical analysis at the end of data collection. Results:The main results found were as follows: the fulfillment rate of the surgical schedule was 95.8%, the cancellation rate was 4.1%, the occupancy rate was 47.9%, the turnover time was 23.1 minutes, the mean delay time in the start of surgeries was 32.8 minutes, length of stay in the post-anesthesia care unit was 37.4 minutes, the professionals' absenteeism rate was 8.94%, and the rates of surgical site infection, operative mortality and work accident were all 0%. Conclusions: Despite the high fulfillment rate of the surgical schedule, the occupancy rate was below the ideal, suggesting that scheduling of surgeries can be improved. In addition, it was shown that the "reserve surgeries" strategy adopted at the hospital helped to reach the goal of scheduled surgeries and to increase the occupancy rate. (AU)