Banca de DEFESA: ERICO DE LIMA VALE

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
DISCENTE : ERICO DE LIMA VALE
DATA : 01/08/2016
HORA: 14:00
LOCAL: Departamento de Saúde Coletiva - UFRN
TÍTULO:

Quality Management in Maternal Intensive Care Unit


PALAVRAS-CHAVES:

Intensive Care Units; Pregnancy-Induced Hypertension; Eclampsia; Quality Management; Pre-Eclampsia.


PÁGINAS: 38
GRANDE ÁREA: Ciências da Saúde
ÁREA: Saúde Coletiva
SUBÁREA: Saúde Pública
RESUMO:

Objectives: To conduct a quality improvement cycle in a maternal intensive care unit (MICU) and assess their impact on multidisciplinary care for patients with gestational hypertensive disease (GHD). Methods: An improvement cycle was conducted from May to July 2015; pre and post intervention were from January to April and from August to October of that year, respectively. The criteria for evaluation were: (1) request for laboratory tests at admission in MICU; (2) obstetrical ultrasound request when admission to the MICU; (3) control of pressure peaks with the use of intravenous hydralazine; (4) use of oral antihypertensive drugs for blood pressure control; (5) use of inhibitors of Angiotensin Converting Enzyme (ACE) inhibitors or Angiotensin Receptor Blockers (ARBs); (6) intravenous fluid restriction; (7) indication of betamethasone steroids in patients with gestational age less than 35 weeks; (8) use of magnesium sulphate (MgSO4) and (9) MgSO4 maintenance postpartum. All women admitted in MICU diagnosed with GHD pre and post intervention were eligible for the study. The implementation of the recommendations was investigated before (n = 50) and after (n = 50) the implementation of the quality improvement cycle. The primary outcome was the rate of overall and individual adherence to evidence-based recommendations in patients with GHD. In each evaluation were calculated 95% confidence intervals for the estimates of compliance, their absolute and relative differences and the Z value (one tail), being considered significant an p <0.05. Results: There was increase in total adherence ratio (p1 = 88 + 3%, p2 = 92 + 1%; p = 0.018) and individual fetal ultrasound request (p1 = 72 + 10%, p2 = 88 + 4%; p = 0.023), and a reduced use of oral anti-hypertensives (p1 = 100%, p2 = 94 + 3%; p = 0.039), there were no significant changes in other criteria. Conclusion: The completion of a quality improvement cycle was associated with an increase in the adhesion rate of the evidence-based recommendations for the treatment of patients with GHD.


MEMBROS DA BANCA:
Presidente - 2495705 - GRASIELA PIUVEZAM
Externo à Instituição - PAULA ADRIANA BORBA RODRIGUES - UNP
Externo ao Programa - 1220598 - VIVIANE EUZEBIA PEREIRA SANTOS
Notícia cadastrada em: 22/07/2016 08:36
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