Padronização do protocolo de manejo da Síndrome de Lise Tumoral da Aliança AMARTE dentro de um hospital universitário da rede EBSERH

Abstract

Standardization of clinical protocols is an essential strategy for improving the quality of care in healthcare services, especially in medium- and high-complexity hospital settings. In pediatric oncology, this practice takes on increased relevance given the complexity of care and the risk of potentially fatal clinical emergencies, such as Tumor Lysis Syndrome (TLS). TLS is a metabolic oncological emergency associated with high morbidity and mortality, whose prognosis requires early recognition, adequate risk stratification, and timely adoption of preventive and therapeutic measures. In this context, collaborative initiatives such as the AMARTE Alliance (Greater Support, Increasing Resources, and Specialized Treatment) play a central role in standardizing pediatric oncological care in Brazil. The objective of this work was to standardize an institutional protocol for the management of Tumor Lysis Syndrome in a university hospital of the EBSERH network (Brazilian Hospital Services Company) accredited for pediatric oncological treatment, based on the AMARTE Alliance's TLS Guideline. This is a descriptive study, developed sequentially in four stages: comprehensive analysis of the AMARTE Alliance Guideline; adaptation of the content to the EBSERH Care Protocol model; understanding and execution of the institutional procedures necessary for validation; and institutional dissemination of the standardized protocol to the sectors directly involved in the care of pediatric patients with TLS, with validation by the respective administrative heads, movements towards institutional alignment, multiprofessional adherence, and the qualification and safety of care. As a result, the institutional flow for the preparation, submission, and processing of care protocols was systematized, including access to official models on the institutional intranet and forwarding the document to the Quality Management Unit for analysis, evaluation, improvement, approval, and publication. The standardization of the institutional protocol for managing TLS represents an advance in clinical governance, contributing to the standardization of procedures, the strengthening of patient safety, and the qualification of pediatric oncological care.