MULTIDISCIPLINARY CHECKLIST IN THE ICU: STRATEGY FOR REDUCING ADVERSE EVENTS IN POSTOPERATIVE CARDIAC SURGERY PATIENTS

Abstract

Cardiovascular diseases are the leading cause of mortality worldwide, associated with risk factors such as high blood pressure, diabetes, smoking, obesity, and dyslipidemia. These conditions increase the risk of recurrent hospitalizations and clinical complications, especially in critically ill patients, highlighting the importance of patient safety strategies and standardized care processes. In Brazil, the National Patient Safety Program promotes the implementation of protocols, manuals, and checklists to prevent adverse events and improve the quality of care. In this context, multidisciplinary practice in Intensive Care Units plays a fundamental role, with emphasis on the inclusion of dentistry as a field capable of reducing infectious complications related to oral health. The mandatory presence of dentists in ICUs, established by Law No. 5,163/2018 in Mato Grosso do Sul, reinforces the need for integrated action to provide safe and qualified care for critically ill patients. This study aimed to develop, implement, and evaluate the effectiveness and applicability of a standardized protocol in an Intensive Care Unit (ICU). It used a structured checklist to promote nursing care, oral health, and systemic health, forming a comprehensive safety strategy for hospitalized cardiac patients. This observational, descriptive, and qualitative study was conducted between 2018 and 2025 at a large teaching hospital located in Dourados, Mato Grosso do Sul, a referral hospital for care within the Unified Health System (SUS). Data collection involved a document review of institutional protocols, analysis of national and international patient safety guidelines, systematic observation of the ICU routine, and analysis of clinical records of patients undergoing cardiovascular surgery. The checklist included steps such as correct patient identification, vital sign monitoring, verification of invasive devices, assessment of clinical stability, medication records, and dental evaluation. The instrument was validated by multidisciplinary experts and continuously reviewed over seven years, ensuring applicability and alignment with regulatory updates. The study was based on the frameworks of humanism and phenomenology, the ethics of care, and the theory of transpersonal care, reaffirming the centrality of the patient and a holistic view of the human being. The results demonstrated that the use of the checklist contributed to the reduction of adverse events, standardization of procedures, and strengthening of communication between teams. Greater adherence to safety practices, more complete clinical records, and integration of dental evaluation into the ICU admission process were observed. The conclusion is that the structured checklist is a viable and effective tool for promoting the safety of hospitalized cardiac patients, fostering multidisciplinary practice and an institutional safety culture. Its expansion to other care settings and further studies evaluating its impacts in different clinical settings are recommended.