Transoperative nursing care in times of COVID-19: An experience report

Abstract

COVID-19 is a disease caused by the new Coronavirus that was identified in China in December 2019, soon after there was already a record of community transmission in Brazil, due to its high transmissibility, combined with the absence of recognized effective treatments. The Surgical Center (CC) is a hospital unit where anesthetic-surgical, diagnostic, and therapeutic procedures are performed, both elective and urgent and emergency. Surgical practices were directly affected because of the COVID-19 pandemic, with the need to suspend elective procedures and prioritize urgent and emergency procedures. In this context, planning to perform surgical procedures in a safer way, both for patients and for the team of professionals, has become a challenge and has been based on new protocols, specific checklists, and new practices for the prevention and control of SARS-CoV-2 transmission. The study aims to report the experience of transoperative nursing care for suspected or confirmed COVID-19 patients. This is an experience report on the planning and implementation of safety measures in transoperative nursing care for suspected or confirmed COVID-19 patients in a CC of a referral hospital in the North Zone of Ceará. Based on the care dynamics of the surgical unit, exclusive operating rooms (OR) were defined to perform surgical procedures in patients with suspected or confirmed cases of COVID-19, in compliance with ANVISA's recommendation, and other rooms for elective procedures that cannot be postponed The recruitment of professionals to compose the on-call staff due to the increase in care demand is highlighted.  their training on care protocols and checklists used in suspected cases of Covid 19 is highlighted. To optimize the organization of the CC unit, information such as the signaling of suspected or confirmed cases of COVID-19 is now required to plan the logistics of patient care, including the exact amount of supplies, equipment, and instruments to be used. This information was included in the surgical notice, which consists of an instrument for communicating the procedure to the CC unit. The number of people in the OR was limited to the minimum team needed for the procedure and it was recommended that leftover surgical instruments and other reusable health products should be sent to the MSC in rigid containers, packed in milky white bags, identified as COVID-19. Subsequently, the tactical team of the sanitation and cleaning service, previously trained, should proceed with the terminal cleaning of the operating room, using the same product, standardized by the institution. It is considered that the elaboration, dissemination and implementation of the training of the protocol and checklist were essential and necessary for the adequacy of the health service. The construction of this new work process evidenced the importance of nurses in leadership, in the continuing education of teams, in the standardization and monitoring of work processes, and in coping with any and all adversities, especially in a surgical unit. Commitment, proactivity and collaborative actions were decisive for safe care, as well as for promoting adequate working conditions for all those involved in the process.

DOI:https://doi.org/10.56238/sevened2024.005-023