And he warns that cases like the one in Rio Grande do Norte could occur again

A failure in the cleaning and sterilization procedures of surgical equipment caused the contamination of 15 of a total of 48 patients after a cataract surgery effort in Parelhas (RN), at the end of September. Of the total number of infected people, nine lost their eyeballs due to the action of the bacteria Enterobacter cloacae, normally found in the intestinal tract. For the Brazilian Council of Ophthalmology (CBO), similar episodes may occur again in Brazil.

In a note, the entity warns that, by not observing minimum criteria defined by medical and health authorities, responsible for joint efforts such as the one in Rio Grande do Norte, “they deprive patients of the necessary effectiveness and safety in these procedures”. In 2022, a joint effort in Rondônia carried out 140 cataract surgeries, with the occurrence of 40 cases of infection. In 2023, in Amapá, there were 141 procedures in a similar initiative, of which 104 presented complications.

With the proposal to reinforce the protection of patients and the maintenance of the quality of the work of ophthalmologists, the CBO made the Ophthalmological Surgery Collective Guide available to public and private managers, health professionals and the general public. The publication provides a series of guidelines, from organizing the joint effort to post-operative care. The text was prepared based on clinical protocols and standards approved by the Federal Council of Medicine (CFM) and the National Health Surveillance Agency (Anvisa).

To avoid new cases of serious adverse events in surgical treatments, the council recommends that joint ophthalmological care be carried out, as a priority, in establishments with a history of providing this type of service in the health region in question. The entity also recalls that, during joint efforts, it is up to local health surveillance authorities to monitor the activities carried out, “in order to ensure that all technical and operational requirements are met”.

“In relation to the execution of clinical and/or surgical procedures, it is essential that it is carried out by doctors with specialist qualification registration (RQE) in ophthalmology”, highlights the CBO. “After carrying out surgical procedures, patients must be monitored for up to 30 days by the responsible team, with immediate notification of adverse events to health surveillance and, in the case of infection, the joint effort must be interrupted until the causes are ascertained. and the appropriate measures were taken.”

The council classifies as “contraindicated” treating ophthalmic patients in mobile units, temporary structures or adapted non-medical hospital establishments. Also according to the entity, managers, when opting to carry out ophthalmological joint efforts, should only hire teams and companies from other states after documented proof of the inability of local services to meet the demand under the same contractual conditions.

The guide also provides specific guidance for doctors who participate in joint efforts. “The professional must be attentive to compliance, by the organizers of the action, with health standards. It is also your responsibility to inform patients about the procedures that will be carried out during the joint effort, as well as their rights, care and clarify their doubts”.

“The doctor has a key role in guiding patients about prescribed medications (dosages, purpose, frequency, possible interactions and side effects), in correctly identifying the location to be operated on and in checking the conditions of the service where the procedures will be carried out, including the conditions for hand hygiene for professionals, patients and companions. Another point of responsibility for the doctor is to inform the patient about the Informed Consent Form and receive it signed.”

The document highlights that patients, family members and companions can contribute to safer care and to reducing cases of adverse events during ophthalmological efforts. “To this end, the public served must act proactively and ask the healthcare team if they have questions or concerns about any procedure that will be performed.”

“Points, such as preparing for surgery, correctly identifying the eye to be operated on and searching for information about prescribed medications, must also be observed by patients and family members. Likewise, they can help control the environment, indicating whether the places where the procedures are carried out have the infrastructure for care.”

The council emphasizes that the patient’s involvement in the process reduces the risk of harm and does not end with the end of the surgery. Among the care listed are:

– avoid touching your eyes, nose and mouth while in the health service;

– never touch other patients or other patients’ belongings;

– find out about what to avoid after surgery, about removing stitches and dressings and when and where you will return to reevaluate the procedure.

Finally, the CBO advises that patients who feel unwell after surgery should immediately report the fact to a healthcare professional or return to the healthcare service where the procedure was performed, especially if they are experiencing symptoms such as fever, redness and secretion at the site of surgery. surgery.