The Ministry of Health has published a technical document of "Recommendations for the programming of surgery in safety conditions during the transition period of the COVID-19 pandemic", the objective of which is to guide hospitals to prepare their local protocols for to reintroduce scheduled surgical activity in hospitals. The objective is to ensure the maximum safety of the patient and healthcare personnel.
The reintroduction of scheduled surgical activity should be done in a staggered and safe manner, but its progressive resumption is essential since "the delay of a surgery can condition the prognosis of some diseases" and "an increase in perioperative morbidity and mortality has been reported in patients with infection with COVID-19 ", said document.
The text indicates that it is important to continuously evaluate the epidemiological conditions of the population where the hospital is located and, therefore, the risk of infection for patients and professionals. It also establishes that it is necessary to create NO-COVID-19 circuits for performing surgical procedures.
The same technical document establishes the recommendations for the design of the programmed surgical care circuit, among which the reduction of in-person consultations and the restriction of the number of visitors stands out. It also includes how to perform active infection screening of patients prior to the scheduled surgical procedure as well as how to prioritize surgeries.
Protection of professionals
The text has a specific section for the general protection of professionals in which the importance of extreme hand hygiene measures, social distance from patients and coworkers, as well as the use of the corresponding PPE when attending to patients suspected of coronavirus.
In addition, in the chapter that collects information from patients and families, the protocol highlights the importance of strengthening it in aspects such as the risks and benefits of undergoing the intervention, based on its comorbidities, center conditions and characteristics of the intervention. It is also highlighted that the patient must be informed of the importance of maintaining basic measures to avoid contagion before, during and after the intervention in their situation.
And, with regard to informed consent, it is emphasized that the patient must be informed of the specific risks of his intervention as well as contagion and complications derived from possible nosocomial infections and especially from COVID-19. This section highlights the essential role of health education for hospitalized patients and their companions at this time.
Multidisciplinary work
This document has been prepared by a working group made up of experts from the Spanish Association of Surgeons (AEC), the Spanish Society of Anesthesiology, Reanimation and Pain Treatment (SEDAR), the Spanish Society of Preventive Medicine, Public Health and Hygiene ( SEMPSPH), the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) and the Spanish Association of Surgical Nursing (AEEQ) and has been coordinated by the General Sub-directorate for Healthcare Quality and Innovation, the Center for Coordination of Health Alerts and Emergencies and the General Directorate of Public Health, Quality and Innovation of the Ministry of Health.
