The projects coordinated by two nurses from Hospital Beatriz Ângelo (HBA), Luísa Matado Caldas and Soraia Pedroso Bispo , were selected to the body of finalist works of Good Practice in Health Award , in the category of best scientific poster. This award is a conjoint initiative of the Portuguese Association for Hospital Development, the Portuguese Directorate-General of Health, the Health System Central Administration and Regional Administrations of Health . Its main purpose is to make known good practices in health at national level , in the scope of quality and innovation, as well as to distinguish the work of professionals or teams in health services/units , that on a daily basis develop projects of quality and innovation, respecting the established rules and representing added value for citizens/community or for organizational practice, with direct impact on healthcare providing. In this 13 th edition of the award , with its final meeting on November 21, about a hundred projects applied. A total of 11 communications and 14 scientific posters were selected as finalists, among them those by HBA professionals: “Stop Falls at HBA: 101 ways of avoiding” - a project presented by Luísa Matado Caldas, coordinator of Risk Management, also integrating nurses Marta Soares, Teresa Alves and Vanessa Pinto); “Un-catheterization Protocol by Nurses” – a project presented by Soraia Pedroso Bispo, nurse responsible for the local cabinet of infection control and prevention, also counting with the participation of physician Carlos Palos (director of the local group of infection control and prevention) and nurses Luísa Caldas, Marta Soares and Teresa Simões. The first project had for starting point the problem of falls and the resulting damages – a problem of public health that the World Health Organization considers a major challenge of the 21 st century – and the concern with the number of falls in HBA. It focuses on the transversal measures developed by the Cabinet of Risk Management of this hospital, in 2016, with the collaboration of several HBA professionals, particularly nurses, aimed at reducing the number of falls and consequent damages for patients, the emotional impact on professionals and the economic impact on the organization. With this intervention, it was verified, in 2017/2018, a 7% reduction in the total number of falls and an annual reduction of 0.1% in the Rate of Fall Incidence in Inpatients (less 74 falls). The project “Un-catheterization Protocol by Nurses” had for starting point aspects related with urinary tract infection associated with catheterization (UTI), one of the most common infections in inpatients, contributing to a raise in morbidity and mortality, prolongation of hospitalization, higher intake of antibiotics and, indirectly, a reduction of accessibility and sustainability of the health system, as well as a raise in antimicrobial resistance. The inserting and removing of the catheter being an interdependent act of nursing, and the nurses being in the front line of the approach to patients, these professionals may play a central role in its management, namely in the removal (un-catheterization), as soon as the justification for its maintenance ceases, in accordance with guiding based on scientific evidence and established at international level (guidance that define and regulates indications for catheterization, good practice of insertion and removal of such catheters). The un-catheterization protocol was introduced in HBA in 2016. In two years – 2017 and 2018 –, it had as result: The prevention of 45 urinary tract infections associated with catheterization in inpatients, reducing to about a half the rate of annual incidence; The reduction of exposure to catheterization and the average number of days of catheterization by patient. Finally, making an extrapolation based on recent studies, we can say that HBA managed to reduce 36 years of life adjusted by impairment in inpatients , as well as to admit more 31 patients , besides achieving significant economy in antibiotics intake and in cases of hospitalization. In the photo above , Luísa Caldas, Carlos Palos, Soraia Pedroso Bispo, Patrícia Nunes (Cabinet of Risk Management) and Marta Soares.
