Hello from Brazil: Open-Heart Observations

Patsy Stinchfield, a Pediatric Nurse Practitioner from Children’s, is in San Jose Rio Preto, Brazil to help the Hospital de Base better control their post-operative infection rates. The following is Patsy’s second update from Brazil.



Our time in Brazil has been wonderful.  We finished our second day in the hospital today.  The surgeons, staff and specialists, including the Infection Control team who have devoted much of their week to being with us, have been outstanding.  They are approachable and interested in improving the quality of care they deliver despite their lack of resources.  They ask significant questions and push themselves to think of new ways to deliver care that is affordable.

Here on behalf of the marvelous Children’s Heartlink program, Dr. Kurachek and I are spending 12-13 hour days in the hospital (and then some serious Brazilian fine dining thereafter!).  I spent most of my day observing open heart surgery in the operating room of Dr. Ulisses Croti, a gifted surgeon and fine human being.

I focused on the process and details of the operating room procedures in relation to infection prevention. They do excellent work and have instituted such things as the pre-op and op “Time Out” on behalf of the safety of the patient and the clear goals of the team.  There are several minor suggestions I can offer, but for the most part feel they are doing great care for very, very sick patients.

Dr. Kurachek has been “holding court” in the ICU with all in attendance eagerly learning from him.  His second Heartlink trip here, he is well-known and well-loved, just like at Children’s.  He worked with the large multidisciplinary team to model rounds and the kinds of questions all should be asking each day: “What concerns you personally most about this patient from your perspective?”, etc.

He provided a long formal class on heart/lung hemodynamics that simplified the complexities of these challenging patients.

We have done many whole team dialogues, small group discussions from our fields and many one on one conversations, including with one amazing young Brazilian mother who is preparing to take her trached baby with Down’s syndrome home for the first time after seven months in the hospital. She said she felt comfortable stopping staff and visitors and asking them to please wash their hands before touching her baby knowing how hard he had fought to get to where he was.  She told me “My son is everything to me” and I told her “And you are everything to him”. Such strength from these moms.


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