O IMPACTO DE ROUNDS MULTIPROFISSIONAIS NOS DESFECHOS CLÍNICOS DE PACIENTES GRAVES EM UMA UNIDADE DE TERAPIA INTENSIVA DE POUCOS RECURSOS: UM ESTUDO RETROSPECTIVO

Abstract

Introduction: Critically ill patients admitted to intensive care units (ICUs) require complex care from multiprofessional teams and a pathway to reduce communication failures and improve the quality of care is the implementation of multiprofessional rounds. Objectives: To evaluate the impact of daily multiprofessional rounds, structured by checklists, on the clinical outcomes of patients admitted to a resource-limited public ICU in Brazil. Methods: A retrospective cohort observational study was conducted between January 2021 and December 2022, including 652 non-COVID-19 patients admitted to the ICU of the Hospital Municipal Djalma Marques (HMDM). The 12 months before and 12 months after the implementation of a multidisciplinary quality program were analyzed, using univariate tests to compare the pre- and post-implementation periods, as well as Pearson correlation. Results: Among the 652 patients analyzed, there was a predominance of males (67% before and 70.9% after, p = 0.52), with similar average occupancy rates (93% before and 99% after, p = 0.71) and average age (46.7 before and 49.3 after, p = 0.71). The post-intervention group presented a higher mean severity (SAPS3 39.4 before and 60.6 after, p = 0.005). Despite the greater severity, standardized mortality was significantly lower (3.7 before and 0.8 after, p = 0.001), as was the average duration of mechanical ventilation (10 days before and 7 days after, p = 0.03). Correlation analysis showed that more severe patients required longer use of invasive devices such as central venous catheters (r = 0.662; p = 0.019). Conclusion: The implementation of daily rounds structured by checklists conducted by a multiprofessional team is associated with reduced mortality and shorter mechanical ventilation duration in ICU patients, highlighting the potential benefit of these practices in resource-limited public ICUs.