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Master's Dissertation
DOI
https://doi.org/10.11606/D.17.2018.tde-13092018-152847
Document
Author
Full name
Marcelo Froes Assunção
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2018
Supervisor
Committee
Angulo, Ivan de Lucena (President)
Júnior, Orlando de Castro e Silva
Lourenço, Dayse Maria
Santis, Gil Cunha de
Title in Portuguese
Avaliação do impacto institucional da implantação de um programa de Patient Blood Management (PBM), construção de um projeto educacional e revisão da literatura
Keywords in Portuguese
Patient Blood Management ; Pilares ; Hemocomponentes ; Protocolo
Abstract in Portuguese
Para muitos médicos de diversas especialidades, a transfusão é considerada a primeira linha na abordagem dos pacientes com anemia e perdas sanguíneas, apesar dos riscos atualmente reconhecidos. Patient Blood Management é uma forma de abordagem das transfusões baseada em um conhecimento multimodal e multidisciplinar, que tem como objetivo central a transfusão de hemocomponentes com base nas necessidades individuais dos pacientes, reduzindo a utilização de hemocomponentes alogênicos às situações em que não existem outras alternativas mais seguras e custo eficazes disponíveis. Neste estudo foram analisados indicadores de eficácia de implantação de um programa de Patient Blood Management, baseados nos pilares consagrados na literatura, particularmente no primeiro e terceiro pilares, que dependem de um envolvimento direto dos médicos para sua efetivação. A implantação de um novo protocolo ocorreu após divulgação interna, palestras e treinamentos para residentes e outros membros do corpo clínico interessados. O resultado do estudo mostrou que a adoção de um novo protocolo, baseado nos conceitos de Patient Blood Management não contribuiu para a mudança efetiva das práticas e em alguns indicadores houve piora em relação às práticas anteriores à sua implantação. Foi realizada também uma revisão bibliográfica sobre o tema e elaborado um programa educacional para estudantes, para os médicos e enfermeiros estudantes e profissionais não familiarizados com o tema.
Title in English
Evaluation of the institutional impact of the implementation of a program of Patient Blood Management (PBM), the development of an educational project and review of the related literature
Keywords in English
Patient Blood Management ; Pillars ; Blood components ; Guideline
Abstract in English
For many doctors of various specialties, transfusion is considered the first line in the approach to patients with anemia and blood loss, despite the currently recognized risks. Patient Blood Management is a way of approaching transfusions based on multimodal and multidisciplinary knowledge, whose main objective is the transfusion of blood components based on the needs of individual patients. This procedure reduces the use of allogeneic blood components in situations where there are safer alternatives and cost-effective solutions. In this study, we analyzed indicators of the effectiveness of the implementation of a Patient Blood Management program, based on the pillars established in the literature, particularly in the first and third pillars, which depend on a direct involvement of the physicians for their implementation. The use of a new protocol took place after an internal disclosure, a number of lectures and a training procedure for both residents and other members of the medical staff. The results of the study showed that the adoption of a new protocol, based on the concepts of Patient Blood Management, did not contribute to the effective change of practices. Some indicators pointed to a worsening of the practices after its adoption. A bibliographic review was also carried out on the topic and an educational program was developed for students, nurse students and professionals who are not familiar with the topic.
 
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Publishing Date
2018-10-04
 
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