Análise da utilização da Escala Quick Sequential Organ Failure Assessment para tomada de decisão na regulação de leitos de UTI

Abstract

Introduction: Among the objectives of the National Policy for Regulation of the Unic Health System (SUS), the organization, control, management and prioritization of access to health care and assistance flows stand out, under the responsibility of public managers and executed by the regulatory complex and its operating units, contemplating medical regulation, exercising health authority to guarantee access based on protocols, risk classification and other prioritization criteria. In Rio Grande do Norte, the State Department of Public Health (SESAP/RN), through the Coordination of Regulation and Health Assessment, and the Regulation Centers (Metropolitan and West) carry out the regulatory process for access to beds in Units Intensive Care Unit (ICU) within the scope of the SUS/RN. Until April 2020, when the Regula RN System was implemented, the Bed Regulation Centers used electronic spreadsheets, emails and communication via telephone contacts to carry out this regulation, which undermined compliance with the SUS principles of equity, completeness and universality. The new Regulation System does not completely eliminate subjectivity in the prioritization criteria for access to the bed, which allows the influence of personal interpretation biases of each professional. Objective: To analyze the use of the Quick Sequential Organ Failure Assessment Scale (qSOFA) as an objective parameter for decisionmaking in regulating access to beds in Intensive Care Units. Methodology: Based on the analysis of the protocol currently used for prioritizing access to beds in the ICU, a survey of the Regula RN System database was carried out and the behavior of the length of stay, the final outcome of the patient who had bed access in the ICU, with the crossing of classifications by bed access priorities and the Quick Sequential Organ Failure Assessment Scale (qSOFA). Results: From the analysis of the extracted data, it was observed the advantages of using the qSOFA Scale as an objective criterion to establish subclassifications of priorities resulting from the criterion currently used, resulting in a shorter hospital stay, consequently a greater turnover of beds, which may result in greater efficiency of regulatory processes in the SUS/RN.