Auditoria ao Cumprimento de Profilaxia Farmacológica do Tromboembolismo Venoso numa Enfermaria de Medicina Interna
DOI:
https://doi.org/10.24950/rspmi/original/163/1/2018Palavras-chave:
Avaliação de Risco, Hospitalização, Tromboembolismo Venoso/prevenção e controloResumo
Introdução: O tromboembolismo venoso (TEV) é a primeira causa de morte intra-hospitalar prevenível. O objetivo deste trabalho foi avaliar o cumprimento de profilaxia farmacológica do TEV
num Serviço de Medicina Interna (SMI), baseado numa guia
própria de avaliação de risco de TEV, instituída como indicador
de qualidade.
Material e Métodos: Estudo observacional transversal decorrido
entre 2010 e 2016. Foram incluídos os doentes admitidos no
SMI na primeira sexta-feira de cada mês e excluídos os hipocoagulados ou ausentes no terceiro dia de internamento. Monitorizou-se o registo de avaliação de risco de TEV e a prescrição
da profilaxia na admissão (D0) e ao terceiro dia (D3). Calculou-
-se a taxa de adequação da profilaxia do TEV (razão entre o
número de doentes a fazer profilaxia adequada e o número total
de doentes incluídos) anualmente, em D0 e D3.
Resultados: Foram selecionados 569 doentes, tendo sido excluídos 149. Dos 420 doentes incluídos, 403 foram considerados
em risco. Destes, 93,3% tinham avaliação de risco registada
no processo clínico na admissão. Apresentavam contraindicação para profilaxia farmacológica 54 doentes. Dos 349 doentes
elegíveis para profilaxia, 86,8% tinham prescrição adequada na
admissão. Verificaram-se poucos erros de prescrição. Em D0 a
taxa de adequação de profilaxia farmacológica foi 88,1% e em
D3 87,6%.
Conclusão: O registo de avaliação do risco é generalizado no
SMI, com uma percentagem de adequação de profilaxia farmacológica muito elevada. A instituição de guias clínicas e a sua
auditoria sistemática permitem conhecer melhor a realidade e
aumentar a boa prática, melhorando a organização em saúde.
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