Ações de controle de infecção das clínicas cirúrgicas ambulatoriais, Campo Grande - MS

Abstract

The infections associated with health care are those acquired during the process of intervention and/or diagnostic procedures in hospital or outpatient environments. When taking into account the complexity of the activities that are developed in outpatient surgical clinics, the considerable increase of procedures in these places, the shortage of information related to infection control in establishments with these characteristics, since the infection control practice is usually focused on the hospital area, this study was aimed at characterizing the conditions for infection control in outpatient surgical clinics. To that end, we conducted a descriptive and observational, cross-sectional study, with a quantitative approach, where the health licensing processes were examined, and the clinics with surgical center were identified, which held procedures with loco-regional anesthesia and general anesthesia with fast elimination. The on-site data collection was performed between April and June 2014 in eight of the 18 invited clinics. Subsequently, we applied a structured script with questions about architectural structure, equipment, materials and presence of supporting documents, added to the consent of information, regarding the processing of materials, structuring, records and infection control surgical processes of the surgical department. The research was approved by the Research Ethics Committee of the Federal University of Mato Grosso do Sul, under Protocol nº 497702/2013. Plastic surgery clinics were predominant in the study (75%), classified as Type III Units (62,5%) and 75% of these made implants, although without systematic record of active search (in the case of implant, there is surveillance up to one year post-procedure). The predominant procedures were augmentation mammoplasty (28,9%), followed by liposuction (17,1%), with higher frequency in females (93%), and epidural anesthesia (47%). As for the processing of materials, 87,5% of clinics had complex molded health products and, of these, 57% performed only manual washing of these objects. Of the six clinics that did not outsourced sterilization, 33,2% did not prove the accomplishment of biological control. In summary, we have found insufficient conditions for infection control within these clinics, and it requires the establishment and implementation of a systematization of prevention and infection control actions, both focused on the surgical department and on the processing of materials, mainly by taking into consideration the profile of performed surgeries and the minimum structuring of the investigated surgical complexes, facts that may provoke irreparable damages to patient safety.