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Cuidar da pessoa com fístula arteriovenosa: modelo para a melhoria contínua
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Authors
Advisor(s)
Abstract(s)
Introduc¸ão e objetivo: Ao longo do século xx, a doenc¸a renal crónica (DRC) adquiriu proporc¸ões
de um problema de saúde pública, mobilizando elevados recursos financeiros e provocando
alterac¸ões sociais. Pretende-se descrever uma estrutura conceptual de prática de cuidados,
que vise a melhoria contínua das terapêuticas de enfermagem direcionadas para a pessoa
com fístula arteriovenosa (FAV).
Material e métodos: Estudo exploratório, descritivo e transversal. A amostra foi constituída
por 98 enfermeiros que prestavam cuidados de enfermagem a pessoas com FAV em hemodiálise
(HD) no distrito do Porto, sendo a média de idades de 36,55 anos e o tempo de exercício
em HD de 8,66 anos. O instrumento de recolha de dados foi o questionário.
Resultados: A estrutura integra 2 áreas de atenc¸ão e cada uma dessas áreas subdividese
em dimensões que, por sua vez, se subdividem em itens, inter-relacionando-se e
complementando-se entre si. No seu conjunto, permitem implementar terapêuticas de
enfermagem. A primeira dimensão designa-se «Capacitac¸ão do Autocuidado», sendo
decomposto um conjunto de terapêuticas de enfermagem, no âmbito do ensino, a desenvolver
em func¸ão do estadio da DRC, que visam promover comportamentos de autocuidado
com o existente ou futuro acesso vascular. A segunda área é designada «Vigilância do
Acesso», descrevendo pormenorizadamente as terapêuticas de enfermagem que contribuem
para a identificac¸ão precoce das complicac¸ões da FAV. Nesta área, são enfatizadas
práticas de cuidados direcionadas para a manutenc¸ão da FAV.
Conclusão: A existência de uma estrutura com áreas de atenc¸ão para a prática do cuidar da
pessoa com FAV facilita o desenvolvimento de competências cognitivas e aquisic¸ão de competências
que permitam aos enfermeiros identificar e diagnosticar precocemente alterac¸ões
no funcionamento da FAV. Essa estrutura reorganiza e esquematiza as áreas de atenc¸ão em
que o enfermeiro pode contribuir para maximizar a longevidade da FAV e minimizar as
implicac¸ões para os sistemas de saúde de cada país.
Introduction and objective: Throughout the twentieth century, chronic kidney disease (CKD) has acquired the proportions of a public health problem, mobilizing financial resources and causing big social changes. It is intended to describe a conceptual framework of nursing practice, seeking continuous improvement of nursing therapies targeted at people with arteriovenous fistula (AVF). Material and methods: This is an exploratory, descriptive and transversal study. The sample consisted of 98 nurses who provided nursing care to people with AVF in hemodialysis (HD) in the district of Porto, with a mean age of 36.55 years. The exercise time in HD is 8.66 years. The instrument for data collection was a questionnaire. Results: The structure contains two focus areas. Each area is subdivided into dimensions, which are subdivided into items, that inter-relate and complement each other. Together they allow you to implement therapeutic nursing. The first dimension is called “Capacity Building of Self-Care”, being decomposed, within the teaching, a set of therapeutic nursing to develop according to the stage of CKD, which promote self-care behaviors with existing or future vascular access. The second area is called “Monitoring of Access,” describing in detail the therapeutic nursing that contributes to early identification of complications of AVF. In this area, care practices aimed at maintaining the AVF are emphasized. Conclusion: The existences of a structure with focus areas for the purpose of taking care of people with ACF facilitates the development of cognitive skills and the acquisition of skills that allow nurses to identify and diagnose early changes in the functioning of the AVF. This structure reorganizes and outlines the areas of care where the nurse can help maximize the longevity of the AVF and minimize the implications for health systems in each country.
Introduction and objective: Throughout the twentieth century, chronic kidney disease (CKD) has acquired the proportions of a public health problem, mobilizing financial resources and causing big social changes. It is intended to describe a conceptual framework of nursing practice, seeking continuous improvement of nursing therapies targeted at people with arteriovenous fistula (AVF). Material and methods: This is an exploratory, descriptive and transversal study. The sample consisted of 98 nurses who provided nursing care to people with AVF in hemodialysis (HD) in the district of Porto, with a mean age of 36.55 years. The exercise time in HD is 8.66 years. The instrument for data collection was a questionnaire. Results: The structure contains two focus areas. Each area is subdivided into dimensions, which are subdivided into items, that inter-relate and complement each other. Together they allow you to implement therapeutic nursing. The first dimension is called “Capacity Building of Self-Care”, being decomposed, within the teaching, a set of therapeutic nursing to develop according to the stage of CKD, which promote self-care behaviors with existing or future vascular access. The second area is called “Monitoring of Access,” describing in detail the therapeutic nursing that contributes to early identification of complications of AVF. In this area, care practices aimed at maintaining the AVF are emphasized. Conclusion: The existences of a structure with focus areas for the purpose of taking care of people with ACF facilitates the development of cognitive skills and the acquisition of skills that allow nurses to identify and diagnose early changes in the functioning of the AVF. This structure reorganizes and outlines the areas of care where the nurse can help maximize the longevity of the AVF and minimize the implications for health systems in each country.
Description
Keywords
Doenc¸a renal crónica Acesso vascular Fístula arteriovenosa Terapêuticas de enfermagem
Pedagogical Context
Citation
Rev Port Saúde Pública. 2012; 30(1):11-17
Publisher
Elsevier España