11th EORNA Congress Valencia, Spain | 16 - 18 May 2024 ePosters 90 476 Improving Patient Safety in Geriatric Surgical Care: A Comprehensive Overview MONICA GONZALEZ CABALLERO1, Esperanza Herranz Adeva1, Monica Garcia Anguas1 1HOSPITAL DEL MAR - CENTRO ESPERANZA, OUTPATIENT SURGICAL UNIT, BARCELONA, Spain Background: The increasing elderly population is a global phenomenon that causes changes in the epidemiology of the surgical patient. Outpatient major surgery unit has represented an advance, allowing more aggressive procedures at extreme ages (1,2). This demographic evolution requires a complete comprehensive assessment given the greater risk of postoperative complications associated with physiological changes, comorbidities and polypharmacy. It is essential that evidence-based practices are implemented to optimize safety and perceived quality (3,4). 3 KEY WORDS: Elderly, Perioperative care, outpatient surgery. Objectives: To analyze the geriatric patient safety in surgical care during the perioperative process. Describe the key factors that contribute to this security and the strategies aimed at reducing risks and improving results. Methods: Review of the literature in different databases (PubMEd, Scopus, SciELO, etc.) on the scientific evidence found in previous studies in relation to the management of geriatric patients in outpatient surgery. Selection criteria such as perioperative care and frail elderly were included. An exhaustive search, evaluation and analysis of articles was carried out. Results: A total of 14 studies were reviewed, including observational studies and systematic reviews, 7 provided a high level of scientific evidence. They highlighted the importance of a thorough preoperative assessment: comorbidities, frailty, functional and cognitive capacity (5,6). The importance of quality nursing care (7) and the multidisciplinary team was also highlighted (8). Good intraoperative management through temperature regulation and fluid optimization was emphasized (9). A multimodal approach to pain control, early mobility, thrombosis prevention, and close postoperative follow-up improve outcomes (10). Conclusion: The elderly patient in outpatient surgery has its own characteristics that require special considerations to guarantee comprehensive care adapted to their needs, reducing additional risk factors. It is important to take into account their fragility and recovery capacity when selecting them for major surgery, through adequate multidisciplinary coordination and adapted strategies. 478 ASD (Atrial Septal defect) Closure : Surgery or Cath Lab? Konstantinos Mintzaridis1, Ioannis Koutelekos2 1CHILDREN HOSPITAL AGIA SOPHIA, CARDIOLOGY WARD, ATHENS, Greece, 2UNIVERSITY OF WEST ATTICA, NURSING, ATHENS, Greece Objectives: Congenital heart disease (CHD) patients represent an important population within cardiac disease, of which atrial septal defect (ASD) is one of the most common diagnoses. Management of ASD encompasses a range of open-heart surgery and minimally invasive approaches, including transcatheter device Methods: The study included patients referred for transcatheter ASD closure and open heart surgery closure during period 2016-2022 in our hopsital. The sample of the study consisted of 123 patients with ASD (secundum) from «Agia Sofia» Children’s hospital during the period of January 2016 – February 2022. Data were collected from patients records and files. Results: One hundred twenty three patients (median weight 24,3 kg, 2-9,5 years, 65% female) were included in the study. Trancatheter defect closure was succesful in 82 of them ( median weight 24,Kg, QP/QS 1,58). In 42 patients the ASD closure was perfomed via open heart surgery (median weight 24,3Kg, median bypass time 45mins, median cross clamp time 22 mins). Conclusion: Transcatheter closure is a widespread technique used to treat secundum atrial septal defects (ASDs). When compared to surgery, it provides a less invasive approach with quicker recovery and reduced physical and psychological impact. Nowadays, almost 85-90% of all secundum ASD can be closed by using a transcatheter approach. However, several limitations may have a significant impact on the feasibility and success of percutaneous ASD closure. Limitations can be grouped as: (I) anatomical; (II) device-related; (III) associated defects and natural history associated issues; (IV) physiological; (V) complications.We should be aware of potential limits of percutaneous ASD closure.
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