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Prevenção de úlceras de pressão em crianças no perioperatório
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| 4.79 MB | Adobe PDF |
Advisor(s)
Abstract(s)
O presente relatório de estágio, foi integrado no 1º Mestrado em Enfermagem Perioperatória, desenvolvido pela Escola Superior de Saúde do Instituto Politécnico de Setúbal e parte de um problema encontrado no decurso do estágio realizado num bloco operatório pediátrico de Lisboa, relacionado com a prevenção de úlceras de pressão nas crianças no bloco operatório.
O Bloco Operatório impõe-nos condições únicas que colocam a criança sujeita a cirurgia em risco de desenvolver úlceras de pressão devido a fatores específicos nomeadamente a fragilidade cutânea. A escala de Braden Q não responde a todas as necessidades específicas desta população, pois quando aplicada, todas as crianças encontram-se em risco de desenvolver úlceras de pressão, para além de não contemplar crianças até aos 21 dias de vida.
No local de estágio verificámos a necessidade de um instrumento normativo que oriente os enfermeiros na identificação de risco, no diagnóstico de enfermagem e na adoção de medidas preventivas.
Para a resolução do problema seguimos a metodologia do projeto. Realizámos uma revisão de literatura onde se encontraram algumas escalas, mas nenhuma estava direcionada às especificidades da criança no perioperatório, à exceção do instrumento Braden Q+P que respondia ao problema de partida, pois identificava grande parte dos fatores de risco encontrados aquando a realização da revisão sistemática de literatura.
Tendo em conta que o instrumento escolhido não estava traduzido e adaptado para Portugal, seguiu-se a metodologia de tradução e adaptação transcultural do instrumento, que culminou numa versão do instrumento final traduzido e adaptado para Portugal, aprovado pela autora do instrumento original, o qual foi incluído na realização da norma de procedimento no serviço.
Consideramos que foi dado o primeiro passo para que os enfermeiros perioperatórios pediátricos venham a ter um instrumento científico validado, mediante critérios rigorosos. Será, no entanto, necessário dar continuidade ao projeto, nomeadamente à comprovação da eficácia e utilidade do instrumento proposto (itens de avaliação e propostas de intervenção).
Abstract: This paper reports the internship period, integrated in the first Master’s Degree in preoperative nursing, developed by the Polytechnic Institute of Setubal, School of Health. It is also part of a problem found during this period, carried out in a Lisbon´s pediatric operating room, related with children pressure ulcers prevention in the operating room. The operating room creates unique situations which put the child under the risk of developing pressure ulcers due to specific factors like skin fragility. However, the Braden Q scale does not respond to all the specific needs of this population, since, when applied, all the children are at risk of developing pressure ulcers. In addition, it also does not apply to children until the first 21 days of life. On-site it was recognized a need for a normative instrument to guide nurses in identifying risk in nursing diagnosis and the adoption of preventive measures. In order to solve this problem, the project methodology was followed. Some scales were found in the literature review stage. Nevertheless, none aimed straightly to children preoperative specificities, exception made to the Braden Q + P since it answers the departure problem because it identifies the main risk factors found in the systematic literature review. Bearing in mind that the chosen instrument (Braden Q + P Scale) wasn’t translated and adapted to the Portuguese reality, a cross-cultural translation and adaptation was carried out and it culminated with the final version of the instrument translated and adapted to Portugal. This final version was approved by the original instrument´s author and in addition it was also included in the unit´s (OR) standard procedures. We consider that the first of many steps towards the obtainment of a scientific valid instrument based on rigorous criteria for pediatric preoperative nurses was taken. However, this project needs to be continued namely to prove the effectiveness and usefulness of the proposed instrument (assessment items and proposals for intervention).
Abstract: This paper reports the internship period, integrated in the first Master’s Degree in preoperative nursing, developed by the Polytechnic Institute of Setubal, School of Health. It is also part of a problem found during this period, carried out in a Lisbon´s pediatric operating room, related with children pressure ulcers prevention in the operating room. The operating room creates unique situations which put the child under the risk of developing pressure ulcers due to specific factors like skin fragility. However, the Braden Q scale does not respond to all the specific needs of this population, since, when applied, all the children are at risk of developing pressure ulcers. In addition, it also does not apply to children until the first 21 days of life. On-site it was recognized a need for a normative instrument to guide nurses in identifying risk in nursing diagnosis and the adoption of preventive measures. In order to solve this problem, the project methodology was followed. Some scales were found in the literature review stage. Nevertheless, none aimed straightly to children preoperative specificities, exception made to the Braden Q + P since it answers the departure problem because it identifies the main risk factors found in the systematic literature review. Bearing in mind that the chosen instrument (Braden Q + P Scale) wasn’t translated and adapted to the Portuguese reality, a cross-cultural translation and adaptation was carried out and it culminated with the final version of the instrument translated and adapted to Portugal. This final version was approved by the original instrument´s author and in addition it was also included in the unit´s (OR) standard procedures. We consider that the first of many steps towards the obtainment of a scientific valid instrument based on rigorous criteria for pediatric preoperative nurses was taken. However, this project needs to be continued namely to prove the effectiveness and usefulness of the proposed instrument (assessment items and proposals for intervention).
Description
Relatório de estágio de Mestrado em Enfermagem Perioperatória
Keywords
Enfermagem Perioperatória Instrumento de Avaliação Metodologia de Projeto Pediatria Prevenção Úlcera de Pressão Perioperative nursing Assessment instrument Project methodology Pediatrics Prevention Pressure ulcer