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Previous issue date: 2016-08-23 / A aten??o ao c?ncer ? uma prioridade da sa?de p?blica mundial, por?m,
ainda nos dias de hoje, persistem falhas simples capazes de repercutir em aumento
da morbimortalidade dos pacientes. O registro inadequado de informa??es cl?nicas
leva ? repeti??o de exames, erros de diagn?stico e tratamento, perda de tempo e
custos desnecess?rios.Este trabalhoobjetivou verificara efic?cia de um ciclo de
melhoria nos registros m?dicosde um hospital de refer?ncia em oncologia, avaliando
o n?vel de qualidade no preenchimento dos prontu?rios, identificando os crit?rios de
qualidade que mais apresentaram erros e analisando a efetividade dos ciclos de
avalia??o cont?nua na melhoria da qualidade do preenchimento dos prontu?rios.
Para tanto, dez crit?rios de qualidade em prontu?rios de pacientescom diagn?stico
de c?ncer de pr?stata foram examinados. A partir de amostragens aleat?rias
simples, procedeu-se ?aprecia??o desses crit?rios, antes e depois das interven??es
propostas. Tais a??es envolveram administradores e m?dicos, sendo direcionadas
especialmente ? conscientiza??o m?dica e reestrutura??o do prontu?rio por
interm?dio de um checklist.No intuito de identificar o n?vel de qualidade,
selecionaram-se a estimativa pontual e o intervalo de confian?a (95%) do
cumprimento dos crit?rios. Para comprovar a efetividade das interven??es, foram
calculadas as melhorias absoluta e relativa entre a primeira e ?ltima avalia??o, assim
como a sua significa??o estat?stica (p<0,05). Na medi??o inicial, verificaram-se
?ndices de cumprimento de 66,4% na m?dia e um total de 411 de n?o
conformidades, significando 34,2% de n?o cumprimento. Destacaram-se, como
maior e menor percentual de n?o cumprimento, os crit?rios patologias associadas,
81,9%, e estadiamento?TNM, 9,5%. J?, na segunda medi??o, notou-se uma
redu??o do n?mero total de defeitos em 49,4%. Em suma, a avalia??o baseada em
crit?rios possibilitou a identifica??o de defeitos de qualidade no preenchimento dos
prontu?rios levantados, o que, por sua vez, direcionou as interven??es propostas.
Considerando as melhorias alcan?adas, percebe-se que o ciclo de melhoria foi
efetivo na diminui??o dos defeitos observados, al?m de auxiliar expressivamente no
progresso da qualidade do registro m?dico. / In spite of the fact that attention to cancer is a global public health priority,
simple failures capable of resonating in the increase of morbidity and mortality of
patients still persist nowadays. The Inadequate recording of clinical information leads
to the repetition of tests, diagnostic and treatment errors, waste of time and
unnecessary costs. This study aims at verifying the effectiveness of a cycle of
improvement of medical records in a referral hospital in oncology, by evaluating the
level of quality in filling in the patient?s medical records, identifying the quality criteria
that presents the greater amount of errors and analyzing the effectiveness of the
continuous evaluation cycles that contributed to the improvement of the quality of
filling in the patient?s medical records. To this end, ten quality criteria in medical
records of patients diagnosed with prostate cancer were examined. From simple
random sampling, these criteria were assessed before and after the proposed
interventions. Such actions involved administrators and doctors, being directed
especially at medical awareness and restructuring of the patient?s medical records via
a checklist. In order to identify the level of quality, the point-in-time estimate and
confidence interval (95%) of the criteria compliance were selected. In order to prove
the effectiveness of interventions, the absolute and relative improvements between
the first and the final evaluation, as well as its statistical significance (p < 0.05) were
calculated. Compliance rates of 66.4%, on average, and a total of 411 nonconformities,
meaning 34.2% of non-compliance were verified in the initial
measurement. The associated pathologies criteria, 81.9%, and staging - TNM, 9.5%,
stood out as the highest and lowest percentage of non-compliance. In the second
measurement, a reduction in the total number of defects of 49.4% was observed. In
short, the criteria-based evaluation made possible the identification of quality defects
in filling in the surveyed patient?s medical records, which, in turn, directed the
proposed interventions. Considering the improvements achieved, it is reasonable to
assume that the cycle of improvement was effective in decreasing the defects
observed, besides contributing significantly to the progress of quality of the medical
record.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/23635 |
| Date | 23 August 2016 |
| Creators | Silva J?nior, Luciano Luiz da |
| Contributors | 00902557475, http://lattes.cnpq.br/9953301230987878, Piuvezam, Grasiela, 02371412481, http://lattes.cnpq.br/0391780760729166, N?brega, Kleber Cavalcanti, 38123967420, http://lattes.cnpq.br/7667731949775312, Souza, Dyego Leandro Bezerra de |
| Publisher | MESTRADO PROFISSIONAL GEST?O DA QUALIDADE EM SERVI?OS DE SA?DE, UFRN, Brasil |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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