SEPSIS CONTEXT IMPROVEMENT CYCLE: strengthening of a clinical protocol in the pediatric axis of a tertiary hospital.
Sepsis; Pediatric; Delivery of health care.
Introduccion: Sepsis is a set of severe manifestations on the whole organism produced by an infection. It is currently, in Brazil, the leading cause of death in Intensive Care Units (ICUs) and one of the leading causes of late hospital mortality, surpassing myocardium infarction and cancer. This health problem also reflects the reality of the hospital in study, corresponding to the primary cause of mortality of admitted patients, especially in the pediatric services. Objective: In view of the exposed problem, this research aims to perform improvement cycle against the sepsis protocol in the pediatric axis, in a tertiary hospital in Ceará. Methodology: This is a qualitative and quantitative study, with a quasi-experimental design, before and after, without a control group, through the promotion of a cycle of quality improvement against the sepsis protocol in the emergency sectors, clinical, and intensive pediatric care unit of a reference hospital in the interior of Ceará, in the biennium 2017/1018. Quality criteria are going to defined according to evidence for the adequate management of sepsis. Interventions will be planned and implemented in a participatory manner with the objective of improving adherence to the quality criteria evaluated. in order to improve adherence to the quality criteria evaluated. After the intervention, reassessments will be made to measure the effects of the intervention and identify remaining opportunities for improvement that may guide the continuity of local actions. We will calculate the point estimate and the confidence interval (95%) of the criteria in each evaluation, the absolute and relative improvement after the intervention, and the statistical significance of the improvement with unilateral Z test. Interventions will also be evaluated qualitatively by healthcare professionals through semi-structured interviews. The ethical precepts of resolution 466/12 are backed up. Expected results: The development of this study aims to strengthen the practices recommended by the pediatric sepsis protocol, favoring the early identification and treatment of sepsis and promoting improvements in the quality of care offered to users.