Melhoria da qualidade do cuidado à hipertensão gestacional em terapia intensiva

Abstract

Objective: to assess the effect of a cycle of quality improvement on the implementation of evidence-based practices in the treatment of women with gestational hypertensive diseas-es admitted to the Maternal Inten-sive Care Unit (MICU).Method: quasi-experimental study, without a control group, performed in a MICU of a university hospital which followed the steps of a cycle of quali-ty improvement. Nine process criteria were assessed in all women admitted with a diagnosis of gestational hyper-tensive diseases in the periods before (n = 50) and after the intervention (n = 50) in 2015. The compliance was estimated with the confidence inter-val of 95 %, the non-conformities with Pareto charts and the significance of improvement with one-tailed Z-test (α = 5 %). Results: the initial quality level was high in six out of nine criteria (ampli-tude: 94-100 %), the practices with the lowest adherence were “magnesium sulfate maintenance” (54 %), “fetal ultrasound request” (72 %) and “intra-venous fluid restriction” (78 %). There was absolute improvement in five out of nine criteria (amplitude: 2-16 %), which was significant for fetal ultra-sound request (absolute improve-ment: 16 %; p = 0.023) and for the total criteria (4%; p = 0.01).Conclusion:the proposed inter-vention of quality improvement increased the adherence to evidence-based recommendations for the treatment of patients with gestation-al hypertension admitted to a MICU