Desenvolvimento e avaliação da viabilidade de um chatbot para vigilância pós-alta hospitalar de pacientes cirúrgicos

Abstract

Introduction: Postoperative surgical site infections have significant impacts on morbidity and mortality; they are considered an adverse health care event. The Board of Directors Resolution (Resolução da Diretoria Colegiada - RDC), No. 8, dated February 27, 2009, describes the importance of epidemiological surveillance of health services that perform surgeries. It aims to search for data on patients underwent surgical procedures, in order to investigate possible infections as well as knowing the outcomes of patients regarding the presence or absence of infection, and finally, qualifying the planning of actions for improvements. Conducting an epidemiological search is the responsibility of the infection control service, and an active search using a prospective and continuous method is mandatory. Objectives: To verify the feasibility of a chatbot developed for post-discharge surveillance of surgical patients. Method: Applied research on chatbot viability for infection monitoring after surgical patient discharge. This process was carried out in two stages: 1) Development of a chatbot. In partnership with a information technology company, which works with a focus on the design of mobile technologies to serve the health segment, the chatbot was developed. 2) assessment of chatbot viability. The feasibility assessment was performed with post-discharge surgical patients, interviewed at the hospital where the study was carried out. In step 2 the patients were included undergoing surgical procedures in a large, private hospital in Rio Grande do Sul. Data collection was performed through the chatbot itself, via the Whatsapp application. Data analysis was performed using descriptive statistics. The research project was approved by the Research Ethics Committee of the institutions involved (proponent and co-participant). The study was guided by Resolution 466/12 of the National Health Council and also by the General Personal Data Protection Law (LGPD), No. 13,709 of August 14, 2018. Results: 132 patients included in this study, who had been submitted to different types of surgeries, were contacted with chatbot messages 30 days after hospital discharge. The data confirmed that the tool has resolution and efficiency, due to the feedback of the users referring to the tool. We are aware that epidemiological surveillance of SSIs and their notification, in addition to care during the procedure, can improve the efficiency of care and reduce the burden of surgical infections. Conclusion: The current study made it possible to verify the feasibility of a chatbot developed for postdischarge surveillance of surgical patients, in a sample of postoperative patients in a large, private hospital located in southern Brazil. Final Product: It was constituted the feasibility of a chatbot developed for post-discharge surveillance of surgical patients as well as its assessment, which was made by those patients. Therefore, during the research, we carry out an epidemiological surveillance as recommended by Anvisa, providing from 15 to 21 days after the surgical procedures, in addition to monitoring the surgical patient in real time without the need for a professional with exclusive dedication, contributing to post-operative care after discharge. The impact of this product is related to greater agility in the post-discharge surveillance process of surgical patients, greater safety in the postoperative period, with a reduction in the risk of adverse events, such as surgical site infections and the early identification of postoperative complications. It is important to draw attention to the device, since it can be replicated in any health setting, whether hospital or primary care, regardless of the complexity of the service, and may contribute to better practices, achieving the soughtafter quality of care. The product was not registered as a patent, as the chatbot is a tool already available, but rather a new idea for using it to innovate in the area of epidemiological surveillance.