Renato Ribeiro Nogueira Ferraz

Incidência de insuficiência renal aguda na Unidade de Terapia Intensiva Neonatal de um hospital paulista

Objectives: To describe the incidence of acute renal failure (ARF) in the neonatal intensive care unit (NICU) of a hospital in Sao Paulo and to verify the use of the “risk of renal failure, injury to the kidney, failure of kidney function, loss of kidney function and end-stage renal failure (RIFLE)” classification for the allocation of the neonates. Methods: Review of medical records of neonates from April 4 to April 25, 2008. Results: Of the 19 admissions in the NICU, 10% were diagnosed as ARF according to the RIFLE classification. The neonates diagnosed with ARF were referred to the dialysis service. Conclusion: Although this study had a very small sample size, the findings indicate that ARF represents 10% of the primary diagnosis among our sample of neonates admitted to the NICU. Large and longer studies are necessary to evaluate the incidence of ARF in the NICU.

Metodologia da Condição Traçadora para Avaliação do Processo Assistencial de Pacientes com Sepse Grave e Choque Séptico

Objetivo: Propor a analise gerencial do processo assistencial utilizando a sepse como doenca tracadora de qualidade. Resultados: Foram avaliados retrospectivamente os prontuarios de 18 pacientes de um unico hospital publico brasileiro. A adesao aos indicadores de qualidade do processo assistencial da sepse, propostos pela Surviving Sepsis Campaign, foi baixa: coleta de lactato = 22%; coleta de hemoculturas = 33%; administracao de antibioticos = 28%; uso de expansores ou vasopressores = 72%; medida de pressao venosa central = zero; medida da saturacao venosa central de oxigenio = 6%. Em nenhum caso houve realizacao conjunta de todos os itens mencionados. Houve permanencia prolongada do paciente no pronto socorro antes da internacao hospitalar, atraso na percepcao e no diagnostico da sepse e indisponibilidade imediata de leito de terapia intensiva para internacao. Conclusao: O atendimento em sepse parece ser sensivel a qualidade da prestacao de servicos em saude.

Pulmonary infection associated with mechanical ventilation as quality indicator of safety in health

1 Hospital São Luiz Gonzaga; São Paulo SP, Brasil.; Universidade Nove de Julho –UNINOVE, Programa de Mestrado Profissional em Administração Gestão em Sistemas de Saúde-PMPA-GSS. São Paulo, SP Brasil. 2 UNINOVE, Programa de Mestrado Profissional em Administração Gestão em Sistemas de Saúde.São Paulo, SP Brasil. 3 Núcleo Municipal de Controle de Infecção Hospitalar da Coordenadoria de Vigilância em Saúde – COVISA. São Paulo, SP Brasil.

Pneumonia associated with mechanical ventilation as an indicator of health quality and safety

Currently, the exclusive use of the outcome indicator in pneumonia (PAV) associated with mechanical ventilation can be considered controversial because it does not express the actual quality and safety of services provided in health. Thus, we intend to analyze the outcome indicator concomitant to the analysis of the process indicator in a protocol for PAV prevention (Bundle). Methods: this was a retrospective, descriptive, and comparative study. The PAV incidence density and the rate of use of mechanical ventilation (VM) were compared before and after the implementation of Bundle using the paired t test in the analysis of outcome indicator. The percentage of adherence to the Bundle’s items was evaluated in the process analysis. Finally, we sought to establish a critical analysis of the studied indicators. Results: the adherence to the Bundle components proved to be lower than expected: elevated decubitus = 62%; oral hygiene = 58%; daily awakening = 34%. Nevertheless, a significant reduction in the median PAV incidence density (2011 = 17.86; 2012 = 11.95; 2013 = 5.88) and median VM utilization rate (2011 = 75%; 2012 = 63%, 2013 = 56%) were observed. Conclusions: it would be possible to question that, institutions with different levels of quality and safety in the assistance, present outcome indicator with Pneumonia associated with mechanical ventilation as an indicator of health quality and safety Sérgio Antônio Pulzi Júnior1, Renato Ribeiro Nogueira Ferraz2, Milton Soibelmann Lapchick3 1 Médico. Mestre. Hospital São Luiz Gonzaga. São Paulo, SP – Brasil. 2 Biólogo. Doutor. Professor Permanente do Programa de Mestrado Profissional em Administração – Gestão em Sistemas de Saúde da Universidade Nove de Julho. São Paulo, SP – Brasil. 3 Médico. Doutor. Coordenador do Núcleo Municipal de Controle de Infecção Hospitalar da Coordenadoria de Vigilância em Saúde – COVISA. São Paulo, SP – Brasil. Pneumonia associada à ventilação mecânica como indicador de qualidade e segurança em saúde DOI: 10.5935/2238-3182.20150116

Incidence of acute renal failure in the Neonatal Intensive Care Unit of a hospital in São Paulo

Objectives: To describe the incidence of acute renal failure (ARF) in the neonatal intensive care unit (NICU) of a hospital in Sao Paulo and to verify the use of the “risk of renal failure, injury to the kidney, failure of kidney function, loss of kidney function and end-stage renal failure (RIFLE)” classification for the allocation of the neonates. Methods: Review of medical records of neonates from April 4 to April 25, 2008. Results: Of the 19 admissions in the NICU, 10% were diagnosed as ARF according to the RIFLE classification. The neonates diagnosed with ARF were referred to the dialysis service. Conclusion: Although this study had a very small sample size, the findings indicate that ARF represents 10% of the primary diagnosis among our sample of neonates admitted to the NICU. Large and longer studies are necessary to evaluate the incidence of ARF in the NICU.

Incidencia de insuficiencia renal crónica aguda en la Unidad de Cuidados Intensivos Neonatal de un hospital de Sao Paulo

Objectives: To describe the incidence of acute renal failure (ARF) in the neonatal intensive care unit (NICU) of a hospital in Sao Paulo and to verify the use of the “risk of renal failure, injury to the kidney, failure of kidney function, loss of kidney function and end-stage renal failure (RIFLE)” classification for the allocation of the neonates. Methods: Review of medical records of neonates from April 4 to April 25, 2008. Results: Of the 19 admissions in the NICU, 10% were diagnosed as ARF according to the RIFLE classification. The neonates diagnosed with ARF were referred to the dialysis service. Conclusion: Although this study had a very small sample size, the findings indicate that ARF represents 10% of the primary diagnosis among our sample of neonates admitted to the NICU. Large and longer studies are necessary to evaluate the incidence of ARF in the NICU.