Análise da reorganização de processos no atendimento de pacientes suspeitos de COVID-19 em um pronto atendimento especializado em otorrinolaringologia e oftalmologia

Abstract

In December 2019 a new infection appeared, of unknown etiology and frighteningly contagious, caused by a virus named SARS-CoV-2. Given this scenario, it is a fact that otorhinolaryngologists and ophthalmologists are at high risk of infection and spread of infection, as they perform procedures at short distances from patients, and in direct contact with mucous membranes that can generate aerosols and droplets. Possible manifestations of COVID-19 disease relevant to the aforementioned specialties, such as changes in the upper airways, loss of smell and taste, in addition to ocular changes, induce suspected individuals to seek out specialist services. Still, asymptomatic patients may seek services due to complaints related to specialties, and not due to COVID-9 disease, leading health professionals to occupational exposure. Faced with this problem, the World Health Organization (WHO) highlights the need for planning in health organizations, such as the creation of a screening service, separating patients suggestive of COVID-19 from other users, enabling the use of protective equipment and improving the training of health professionals. In the meantime, the present work proposed to identify the organizational changes of a specialized emergency service in the areas of otolaryngology and ophthalmology, aiming to create new processes in order to demonstrate the competence in the work practice. To this end, a single case study was conducted, with a qualitative and descriptive approach, guided by semi-structured interviews with 21 health professionals, in addition to analysis of internal documents and an institutional video. As a result, 255 stretches of narratives were selected, linked to 21 codes, grouped into 7 categories. The study allowed to identify combinations of evidence related to the flows of suspected patients, structural changes, training, dimensioning and use Personal Protective Equipment (PPE), considered essential to reduce nosocomial transmission.