Processo de enfermagem em unidade neonatal: proposição de um conjunto de dados mínimos de enfermagem
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2019-08-11
Autores
Fermiano, Rosemary [UNESP]
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Universidade Estadual Paulista (Unesp)
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Objetivo geral: Elaborar conjunto de dados mínimos de enfermagem para operacionalização do processo de enfermagem em Unidade de Terapia Intensiva Neonatal com a participação de enfermeiras com experiência nesta área de atuação. Objetivos específicos: Analisar a operacionalização do processo de cuidar em enfermagem em uma Unidade de Terapia Intensiva Neonatal a partir da aplicação do processo de enfermagem; identificar as percepções das enfermeiras sobre a utilização do processo de enfermagem em unidade neonatal de um serviço público de referência para atendimento a recém-nascidos de alta complexidade; realizar oficina de trabalho para definição dos dados a serem incluídos e organizar conjunto de dados mínimos de enfermagem para a área neonatal. Método: Trata-se de estudo misto. O cenário de estudo é um hospital de ensino, referência para atendimento a gestantes e recém nascidos de risco. A identificação da aplicação do processo de enfermagem desenvolvido foi realizada a partir da consulta aos registros do prontuário eletrônico de todos os recém-nascidos internados na Unidade Neonatal em 2017; as percepções das enfermeiras sobre o processo de enfermagem foram obtidas por abordagem qualitativa, tendo como participantes as enfermeiras da referida unidade, adotando-se o referencial metodológico do Discurso do Sujeito Coletivo; o conjunto de dados mínimos de enfermagem para área neonatal produzido a partir de oficinas com alunos e enfermeiros, teve por referência a classificação de enfermagem da NANDA Internacional. A análise dos dados quantitativos foi realizada de forma descritiva e os Discursos do Sujeito Coletivo construídos foram discutidos com base no princípio da integralidade em saúde. O conjunto de dados mínimos incluiu histórico neonatal; problemas de enfermagem relacionados às Necessidades Humanas Básicas, diagnósticos de enfermagem, indicadores de evolução dos diagnósticos de enfermagem, intervenções e prescrição de enfermagem. Pesquisa aprovada por Comitê de Ética em Pesquisa local. Resultados: o processo de enfermagem foi aplicado a 1,8% dos bebês internados na unidade neonatal deste estudo no ano de 2017. Quanto à percepção das enfermeiras sobre o processo de enfermagem, apesar de apontarem a importância deste, há certa desmotivação quanto a sua implementação, devido a forma de organização de seu processo de trabalho, ausência de um sistema de informações adequado e falta de oferta de ações de educação permanente sobre essa tecnologia. O conjunto de dados mínimos de enfermagem foi construído por domínios da NANDA Internacional: fisiológico, mental, existencial, funcional, segurança, família e ambiente. Conclusões: o registro do processo de enfermagem praticamente não é utilizado na instituição. Para superar os entraves a sua implantação, deverá haver maior valorização do trabalho do enfermeiro e o devido apoio às mudanças pertinentes a seu desenvolvimento, com vistas ao cuidado integral em saúde dos recém-nascidos e suas famílias. O conjunto de dados mínimos poderá contribuir com essa implantação, visto que sua operacionalização será facilitada.
General objective: To elaborate a nursing minimum data set of for operationalization of the nursing process in Neonatal Intensive Care Unit with the participation of nurses with experience in this area. Specific objectives: To analyze the operationalization of the nursing care process in a Neonatal Intensive Care Unit from the application of the nursing process; to identify nurses' perceptions about the use of nursing process in a neonatal unit of a public referral service to care for highly complex newborns; to hold a workshop to define the data to be included and to organize a nursing minimum data set for the neonatal area. Methods: This is a mixed study. The study scenario is a school hospital, a reference for care of pregnant women and newborns at risk. The identification of the application of the nursing process developed was based on the consultation of the records of the electronic records of newborns admitted to the Neonatal Unit in 2017; the nurses' perceptions about the nursing process were obtained through a qualitative approach, taking as participants the nurses of the unit, adopting the methodological reference of the Discourse of the Collective Subject; the nursing minimum data set for neonatal area produced from workshops with students and nurses was based on the NANDA International nursing classification. The analysis of the quantitative data was made in a descriptive way and the Collective Subject Discourses constructed were discussed based on the principle of integrality in health. Nursing minimum data set included a neonatal history; nursing problems related to Basic Human Needs, nursing diagnoses, indicators of the evolution of nursing diagnoses, interventions and nursing prescription. Research approved by the local Research Ethics Committee. Results: Nursing process was applied to 1.8% of infants admitted to the neonatal unit of this study in 2017. Regarding nurses' perceptions about the nursing process, although they point out the importance of this, there is some lack of motivation regarding its implementation, due to form of organization of its work process, absence of an adequate information system and lack of offer of permanent education actions on this technology. The nursing minimum data set was built by NANDA International domains, namely: physiological, mental, existential, functional, safety, family and environment. Conclusions: The nursing process registry was performed in a few visits to the neonatal unit in the year 2017. In order to overcome obstacles to its implementation, there should be a greater appreciation of the nurses' work and due support for changes pertinent to their development, with a view to the health care of newborns and their families. The nursing minimum data set can contribute to the implementation of the nursing process in the service, since its operationalization will be facilitated.
General objective: To elaborate a nursing minimum data set of for operationalization of the nursing process in Neonatal Intensive Care Unit with the participation of nurses with experience in this area. Specific objectives: To analyze the operationalization of the nursing care process in a Neonatal Intensive Care Unit from the application of the nursing process; to identify nurses' perceptions about the use of nursing process in a neonatal unit of a public referral service to care for highly complex newborns; to hold a workshop to define the data to be included and to organize a nursing minimum data set for the neonatal area. Methods: This is a mixed study. The study scenario is a school hospital, a reference for care of pregnant women and newborns at risk. The identification of the application of the nursing process developed was based on the consultation of the records of the electronic records of newborns admitted to the Neonatal Unit in 2017; the nurses' perceptions about the nursing process were obtained through a qualitative approach, taking as participants the nurses of the unit, adopting the methodological reference of the Discourse of the Collective Subject; the nursing minimum data set for neonatal area produced from workshops with students and nurses was based on the NANDA International nursing classification. The analysis of the quantitative data was made in a descriptive way and the Collective Subject Discourses constructed were discussed based on the principle of integrality in health. Nursing minimum data set included a neonatal history; nursing problems related to Basic Human Needs, nursing diagnoses, indicators of the evolution of nursing diagnoses, interventions and nursing prescription. Research approved by the local Research Ethics Committee. Results: Nursing process was applied to 1.8% of infants admitted to the neonatal unit of this study in 2017. Regarding nurses' perceptions about the nursing process, although they point out the importance of this, there is some lack of motivation regarding its implementation, due to form of organization of its work process, absence of an adequate information system and lack of offer of permanent education actions on this technology. The nursing minimum data set was built by NANDA International domains, namely: physiological, mental, existential, functional, safety, family and environment. Conclusions: The nursing process registry was performed in a few visits to the neonatal unit in the year 2017. In order to overcome obstacles to its implementation, there should be a greater appreciation of the nurses' work and due support for changes pertinent to their development, with a view to the health care of newborns and their families. The nursing minimum data set can contribute to the implementation of the nursing process in the service, since its operationalization will be facilitated.
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Palavras-chave
Recém-nascido, Unidades de Terapia Intensiva, Processo de enfermagem, Cuidados de enfermagem, Newborn, Intensive Care Unit, Nursing process, Nursing care