Prevalence of Performed Surgeries, Causes, Readmissions, and Mortalities in a Third-Level Hospital in Colombia

Sunday, 29 October 2017: 4:35 PM

Wilmar José Lopez Zuluaga, RN
Grupo de investigación en cuidado perioperatorio, Universidad Nacional de Colombia, Bogotá, Colombia
Karen Tatiana Roa Lizcano, MSc
School of Nursing, National University of Colombia, Bogota, Colombia

The identification and analysis of health indicators are of vital importance in the epidemiology for the orientation of health interventions and in this case for the improvement of the surgical processes. During the 68th WORLD HEALTH ASSEMBLY (Assembly & Health, 2015), in the framework of strengthening essential and emergency surgical care and anesthesia, as components of universal health coverage, the following considerations were taken into account:
• More than 234 million surgeries are performed worldwide each year for a wide range of conditions in patients of all ages and in all Member States.
• Many conditions that require surgical care - such as obstructed labor, congenital anomalies, diabetes, cancer, cardiovascular disease, hernias, cataracts or injuries due to traffic accidents, burns and falls - are common and affect To all socioeconomic and ethnic groups.
• Diseases that can be treated surgically are among the 15 leading causes of disability worldwide. According to conservative estimates, 11% of the burden of global morbidity is due to conditions that can be treated effectively by surgery, and the proportion is even higher in low- and middle-income countries.
• Failure to treat these conditions increases maternal mortality rates and causes minor surgical conditions and treatable injuries to be fatal.
Surgical intervention is at some point a possible treatment for almost all diseases included in the 2010 global burden of disease study (Assembly & Health, 2015).

 For this reason, the measures to be taken are for countries to improve data collection, monitoring and evaluation for decision-making and policies, stating that it is necessary to implement evidence-based plans and policies in order to ensure the expansion Satisfactory access to essential surgical services. Monitoring and evaluation are necessary to ensure and support better access to surgical services and their quality and safety. And proper surgical records and proper follow-up are crucial to ensure the safety of procedures and their monitoring.

In Colombia, there are no studies that describe indicators and prevalence related to surgical interventions, readmissions, mortality, morbidity and causes of such interventions. Therefore, the main objective is to identify and analyze these variables, in order to guide nursing work and interventions to improve the care conditions during the surgical process and, therefore, the safety and quality of care. A quantitative, descriptive and retrospective study was carried out, based on the information contained in the databases of a Hospital of the third level of complexity of the city of Bogotá where the study was applied and which includes data related to the Patients and their procedures. Inclusion criteria included patients of all ages, men, women and children who underwent surgery during the period between January and December 2015. The institution's ethical endorsement was obtained for obtaining the information. Statistical analysis was performed by obtaining relative and absolute frequencies, measures of central tendency and the identification of prevalences, using the statistical tool Epiinfo as support for data processing. Among the results, the prevalence of surgeries performed, types of surgeries, morbidity, readmissions and mortality were identified, in order to guide care practices according to the present population, to generate interventions aimed at improving safety And the conditions of care during the surgical process in order to improve nursing practice during the perioperative process. Also within the discussion and conclusions arises the need for the nurse to be effectively involved in the preoperative intraoperative and immediate and late postoperative processes in order to ensure cost effective and safe care.