A influência do planeamento da alta hospitalar no número de dias de internamento do doente
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Data
2015
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Resumo
Atualmente, nas instituições hospitalares, prevalece a lógica biomédica, que se pauta,
em geral, pela falta de articulação multidisciplinar nos serviços de internamento, à data da alta
hospitalar e que ignora, muitas vezes, os processos de aprendizagem e aquisição de
conhecimentos por parte do doente e da sua família. Esta reflexão levanta a questão dos
efeitos positivos que poderá ter um planeamento integrado da equipa multidisciplinar com os
doentes/famílias.
Objetivo geral: averiguar a existência de fatores do planeamento da alta hospitalar do
doente que se relacionam com o número de dias que este permanece internado.
Métodos: foi elaborada uma grelha de observação para recolher dados dos processos
clínicos de 100 doentes internados no serviço de Ortopedia do CHLN. Trata-se de um estudo
quantitativo, descritivo-correlacional.
Resultados: verificou-se, na sua generalidade, que os objetivos foram alcançados, na
medida em que se concluiu que existem fatores que, estando presentes ou ausentes no
planeamento da alta do doente, influenciam o número de dias que este permanece internado
São eles: a organização e agendamento das cirurgias; o tipo de diagnóstico e a respetiva
cirurgia; o contributo dos diferentes profissionais envolvidos; a transmissão de informação e a
comunicação entre os elementos da equipa multidisciplinar; o momento em que se inicia a
preparação da alta; a participação do doente e família no processo da alta; os ensinos
realizados ao doente e família.
Conclusões: constata-se que é importante implementar um plano integrado de
preparação da alta hospitalar, a iniciar-se no momento da admissão, que envolva toda a
equipa multidisciplinar, o doente e a sua família. Isto permitirá diminuir a duração do
internamento, reduzir os custos a ele inerentes e minimizar os efeitos negativos que resultam
de uma hospitalização.
Nowadays, at the hospitals, the biomedical is the main criteria, which lacks the multidisciplinary approach defining clinical discharge date, at hospital internment services and, many times, ignores the learning and knowledge acquiring processes by the patient and its family. This study raises the question about the positive effects achieved by a proper, integrated planning by the entire clinical staff onto the patients/families. Overall objective: to determine the existence of hospital patient's planning factors that relate to the number of days that one remains hospitalized. Methods: it was created an observation grid in order to register the data collected concerning the 100 patients clinical processes, admitted at the CHLN orthopaedics department. This is a quantitative, descriptive-correlational type study. Results: overall the objectives were achieved, since one concluded that the number of internment days is directly influenced by the presence or absence of certain hospital discharge planning factors, such as: surgery organization and scheduling; type of diagnosis and proper surgery; communication amongst multidisciplinary staff members as well as individual contributions; the moment when discharge preparation starts; involvement of patient and its family in the discharge process as well as the information they receive. Conclusions: one can corroborate the need to implement an integratedhospital discharge plan, beginning at admission time and involving multidisciplinary team, patient and his family. This will enable the decrease of internment days and related costs as well as minimize negative effects involving an internment.
Nowadays, at the hospitals, the biomedical is the main criteria, which lacks the multidisciplinary approach defining clinical discharge date, at hospital internment services and, many times, ignores the learning and knowledge acquiring processes by the patient and its family. This study raises the question about the positive effects achieved by a proper, integrated planning by the entire clinical staff onto the patients/families. Overall objective: to determine the existence of hospital patient's planning factors that relate to the number of days that one remains hospitalized. Methods: it was created an observation grid in order to register the data collected concerning the 100 patients clinical processes, admitted at the CHLN orthopaedics department. This is a quantitative, descriptive-correlational type study. Results: overall the objectives were achieved, since one concluded that the number of internment days is directly influenced by the presence or absence of certain hospital discharge planning factors, such as: surgery organization and scheduling; type of diagnosis and proper surgery; communication amongst multidisciplinary staff members as well as individual contributions; the moment when discharge preparation starts; involvement of patient and its family in the discharge process as well as the information they receive. Conclusions: one can corroborate the need to implement an integratedhospital discharge plan, beginning at admission time and involving multidisciplinary team, patient and his family. This will enable the decrease of internment days and related costs as well as minimize negative effects involving an internment.
Descrição
Orientação: Vasco Reis ; co-orientação: Manuel Delgado
Palavras-chave
GESTÃO DE UNIDADES DE SAÚDE, GESTÃO HOSPITALAR, INTERNAMENTOS HOSPITALARES, PLANEAMENTO, DOENTES, HEALTH CARE FACILITIES MANAGEMENT, HOSPITAL MANAGEMENT, HOSPITALIZATION, PLANNING, PATIENTS