Cuidado integral à saúde da criança e sua família: tecnologia de apoio ao planejamento da alta hospitalar
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Data
2019-07-31
Autores
Oliveira, Elaine Garcia de
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Universidade Estadual Paulista (Unesp)
Resumo
Introdução: esta pesquisa volta-se à temática da sistematização da assistência de enfermagem, destacando como objeto de estudo,estratégias facilitadoras do planejamento da alta hospitalar pediátrica para a promoção do cuidado integral em saúde. Objetivo: elaborar tecnologia informatizada de apoio ao planejamento de alta pelo enfermeiro visando promover o cuidado integral em saúde. Método: esta pesquisa foi realizada em uma unidade de internação pediátrica hospitalar e foram desenvolvidos três estudos: revisão integrativa da literatura cientifica sobre estratégias voltadas ao planejamento da alta hospitalar pediátrica pelo enfermeiro para promover o cuidado integral em saúde da criança e sua família; estudo de abordagem qualitativa sobre a perspectiva de enfermeiros atuantes em unidade de internação pediátrica, através de dados coletados por meio de entrevistas semiestruturadas e analisados segundo técnicas de Análise de Conteúdo Temática; e estudo transversal dos registros da sistematização da assistência de enfermagem e do processo de enfermagem contidos em prontuários eletrônicos de amostra probabilística de crianças menores de dois anos internadas de janeiro a dezembro de 2017, utilizando questionário estruturado e empregando-se estatística descritiva na sua análise. Resultados: foram identificados dez artigos que preencheram os critérios de inclusão na revisão de literatura, cuja análise integrada revelou que para se realizar o planejamento da alta hospitalar com vistas ao cuidado integral em saúde da criança, é importante a implementação de ações educativas durante a internação, valorizando a abordagem centrada na criança, o estabelecimento de vínculo com a família desde a admissão hospitalar e a sua participação nesse processo. Foi constatada incipiência de referências sobre estratégias de articulação entre a atenção hospitalar e a primária em saúde. Dos depoimentos das enfermeiras emergiram três categorias temáticas: Propósitos da sistematização da assistência de enfermagem; Implementação da sistematização da assistência de enfermagem na unidade pediátrica; Planejamento de alta hospitalar no contexto da sistematização da assistência de enfermagem pediátrica. Os achados dos estudos realizados, subsidiaram a elaboração de documento técnico contendo:fluxograma da alta hospitalar pediátrica, com as respectivas ações de enfermagem; formulário de prescrições de enfermagem para o cuidado integral no domicílio e formulário eletrônico do plano de enfermagem paraalta hospitalar pediátrica.Considerações finais:o documento técnico elaborado apresenta a proposta de tecnologia informatizada de apoio ao planejamento de alta pelo enfermeiro, contemplando aspectos fundamentais a serem considerados para a promoção do cuidado integral em saúde da criança.Dentre esses aspectos, destaca-se recomendação de se assegurar, no processo de alta hospitalar pediátrica,o envolvimento ativo da família, a articulação do hospital com os serviços de atenção primária à saúde e oinvestimento institucionalna qualificação do processo de trabalho do enfermeiro, valorizando suas potenciais contribuições para a viabilizaçãoda alta hospitalar pediátrica segura e responsável
Introduction: the theme of this research is the systematization of nursing assistance, which highlights the enabling strategies of pediatric hospital discharge and also the promotion of integral health care. Objective: elaborate computerized technology which offers support for the hospital discharge, when made by the nursing team, aiming to promote integral health care. Methodology: this research was carried out in an admission’s pediatric hospital unit and three studies were conducted: Integrative scientific literature review of strategies surrounding pediatric hospital discharge by the nursing team to promote integral care for children and their families; Qualitative approach about the perspectives of working nurses of the pediatric admissions unit through data collection in semi structured interviews and its analysis in accordance with the content analysis technique; and cross sectional observational study of the nursing team's systematization records and the nursing process which were in the electronic patient's record with probability samples from children under the age of two who were admitted from January to December of 2017, using structured questionnaire and applying descriptive statistics in its analysis.Results: ten articles that fit the criteria were identified for the literature review and in which the integrated analysis revealed that, in order to make the hospital discharge planning, keeping children’s integral care in mind, it is important to introduce educational activities during the admission, valuing children’s centralized approach, establishing connection with the children’s family since the moment of admission and their participation in this process. It was noted the incipience of references about the articulation strategies between the hospital’s attention and the primary health. From the nursing team’s statements three themed categories were found: 1- Purposes of the nursing assistance’s systematization; 2- Introduction of the nursing assistance’s systematization in children’s unit; 3- Planning hospital discharge in the context of the children’s nursing assistance’s systematization. Based on what was found in this study, a technical document was elaborated, containing the following nursing actions, prescription form with detailed information about the integral health care at home and the electronic form of nursing team’s hospital discharge. Final considerations: the technical document created presents the proposal of computerized technology supporting the hospital discharge planning made by the nursing team, contemplating fundamental aspects to be considered for the promotion of integral health care in children’s health care. Among these aspects, it can be highlighted the family’s involvement, the communication between primary health services and the institutional investment in qualifying the 3 nursing team’s work, valuing their potential contributions to make feasible safe and responsible pediatric hospital discharge
Introduction: the theme of this research is the systematization of nursing assistance, which highlights the enabling strategies of pediatric hospital discharge and also the promotion of integral health care. Objective: elaborate computerized technology which offers support for the hospital discharge, when made by the nursing team, aiming to promote integral health care. Methodology: this research was carried out in an admission’s pediatric hospital unit and three studies were conducted: Integrative scientific literature review of strategies surrounding pediatric hospital discharge by the nursing team to promote integral care for children and their families; Qualitative approach about the perspectives of working nurses of the pediatric admissions unit through data collection in semi structured interviews and its analysis in accordance with the content analysis technique; and cross sectional observational study of the nursing team's systematization records and the nursing process which were in the electronic patient's record with probability samples from children under the age of two who were admitted from January to December of 2017, using structured questionnaire and applying descriptive statistics in its analysis.Results: ten articles that fit the criteria were identified for the literature review and in which the integrated analysis revealed that, in order to make the hospital discharge planning, keeping children’s integral care in mind, it is important to introduce educational activities during the admission, valuing children’s centralized approach, establishing connection with the children’s family since the moment of admission and their participation in this process. It was noted the incipience of references about the articulation strategies between the hospital’s attention and the primary health. From the nursing team’s statements three themed categories were found: 1- Purposes of the nursing assistance’s systematization; 2- Introduction of the nursing assistance’s systematization in children’s unit; 3- Planning hospital discharge in the context of the children’s nursing assistance’s systematization. Based on what was found in this study, a technical document was elaborated, containing the following nursing actions, prescription form with detailed information about the integral health care at home and the electronic form of nursing team’s hospital discharge. Final considerations: the technical document created presents the proposal of computerized technology supporting the hospital discharge planning made by the nursing team, contemplating fundamental aspects to be considered for the promotion of integral health care in children’s health care. Among these aspects, it can be highlighted the family’s involvement, the communication between primary health services and the institutional investment in qualifying the 3 nursing team’s work, valuing their potential contributions to make feasible safe and responsible pediatric hospital discharge
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Palavras-chave
Criança, alta hospitalar, enfermagem, integralidade em saúde, children, hospital discharge, nursing, integral health care