Pacientes pediátricos onco hematológicos na Enfermaria de Pediatria do Hospital Naval Marcilio Dias (HNMD): análise sobre repercussões e necessidade

Abstract

Childhood cancer has high complexity and its treatment must be comprehensive, requiring attention to both physical, psychological and social needs, including the participation of the family, in an ambulatory and hospital approach. In oncology units, it is common we find patients with long hospitalizations, and humanization must be present due to the psychological frailty of the child and his family. Currently, treatment can be performed in part through outpatient follow-up and hospital admissions considered unnecessary should be avoided. The object chosen for this intervention project was to organization of the oncohematological pediatric hospitalization service at Hospital Naval Marcilio Dias, aiming to reduce the number of unnecessary hospitalizations of patients oncohematological pediatric patients. After analysis of the medical records of from 2016 to 2020, 32.5% of the hospitalizations were unnecessary, for administration of medications that could be ambulatory, by transfusions that could be performed without the patient staying more than 24 hours in the hospital and by living distant from the patient, making it impossible to discharge with return on the day following the treatment. The possibility of reducing the period of hospitalization with the institution of Hospital Day structure and agreement with support houses, contributes to the improvement of quality of life, reducing the number of days that the child remains away from his home and its usual routine, in addition to allowing the cost reduction for the health system. The project's objectives have been achieved, despite delays due to the COVID-19 pandemic, through the development of an action programming matrix that provides for the establishment of agreements with support homes and the establishment of new procedures for hospitalization, optimizing the times for administering chemotherapy and blood products and for admission to the Infirmary.