Segurança do processo transfusional em pacientes cirúrgicos de um hospital público de ensino do interior de Minas Gerais

• Ano de defesa: 2020
• Autor(a) principal: GARCIA, Josiane
• Orientador(a): SOUZA, Helio Moraes
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal do Triângulo Mineiro
• Programa de Pós-Graduação: Programa de Pós-Graduação em Medicina Tropical e Infectologia
• Departamento: Instituto de Ciências da Saúde - ICS::Curso de Medicina
• País: Brasil
• Palavras-chave em Português: Segurança transfusional.; Transfusão sanguínea.; Uso racional de hemocomponentes.; Perioperatório.; Reação transfusional.
• Palavras-chave em Inglês: Transfusion safety.; Blood transfusion.; Rational use of blood components.; Perioperative period.; Transfusion reaction.
• Área do conhecimento CNPq: Medicina; Enfermagem Médico-Cirúrgica; Hematologia
• Link de acesso: http://bdtd.uftm.edu.br/handle/tede/1051

Introduction: Blood transfusion is an effective therapeutic method, universally used and with specific indication for each blood component (HC). However, even adopting all procedures for transfusion safety, there are risks, one of which is immediate adverse reactions, requiring compliance with the protocols and constant training of the teams. Objective: To evaluate the safety of the transfusion process in surgical patients attending a public teaching hospital in the state of Minas Gerais from October 2018 to August 2019 Methods: Quantitative, descriptive, exploratory, prospective study. The data were obtained by monitoring the records used by the medical and nursing staff, from the request of the blood component up to 24 hours after its placement, in order to assess the performance of the service and to identify possible transfusion reactions. Results: A total of 393 transfusion events were evaluated in 184 patients, including 54.0 % male, 53.0% whites, 38% browns, and 9.0% blacks. Of these, 19.5% ranged in age from 18 to 39 years, 26.5% from 40 to 59 years, and 54.0% were 60 years or older. The most common blood type of the transfused patients was O (43.0%), followed by A (40.0%). The surgical speciality that most indicated transfusion was orthopedics (28.2%) and most transfusions were performed at the intensive care/coronary units (34.35%). Packed red blood cells were the most frequently transfused blood component (61.6%). The following indications were considered inadequate according to the criteria of the Protocol for Rational Blood Use of HC/UFTM: 15% of packed red blood cell transfusions, 20% of plasma transfusions, 29.2% of platelet transfusions, and 36.4% of cryoprecipitate transfusions. Filling out the blood components request forms, the nursing checklist and the entry book were inadequate in 88.3%, 92.8% and 69.5% respectively. The medical prescription of HC was not present in 20.1% of the cases and in 94.9% no signed term of science was found A total of 1.042 blood component bags were transfused and 17 transfusion reactions were identified. None of them was reported to the Transfusion Agency. Febrile non-hemolytic transfusion reactions were the most common. In conclusion, failures were identified in the entire transfusion process, which involves multiple and complex steps and requires thorough knowledge of the nursing team and the medical team regarding transfusion therapy. These steps need to be followed in accordance with current legislation and the protocols implemented in health institutions to minimize the occurrence of errors.