Tecnologia digital para sistematizar o cuidado de enfermagem com as lesões por pressão em pacientes de Unidade de Terapia Intensiva

Abstract

Pressure injuries are an important health problem worldwide, being a significant cause of morbidity and mortality for patients admitted to the intensive care unit. This damage represents a challenge for health services, which have found in technology a promising alternative to optimize their work processes and resolve the complications related to these events. Given this reality, the objective was to build and validate a digital technology to systematize nursing care with pressure injuries in intensive care unit patients. It is a methodological development research, with a quantitative approach, which had Design Science Research as a methodological reference, being operationalized through five steps. In the first one, the problem was identified through an integrative literature review, which aimed to verify whether the use of technologies reduces the incidence or worsening of pressure injuries. The second step, called suggestion, sought to build the domains, items and appearance of digital technology, using the Nursing Process as a theoretical framework. The third step, development, referred to the construction of digital technology, with the collaboration of specialists in the field of information technology, using the Model-View-Controller (MVC) as an architectural model. The fourth step focused on validating the content and appearance of the technology with eight nurses experienced in care or research involving patients with skin lesions or the Nursing Process. The research followed all ethical and legal aspects of research on human beings, obtaining the Opinion of the Research Ethics Committee under No. 4,891,206. The selected studies showed that the use of technology helps Nursing care with pressure injuries, reducing their incidence by up to 20%. Initially, the technology content comprised the five domains referring to the phases of the Nursing Process and 51 items. The technology interface and architecture were developed according to the aforementioned items and domains. Then, the validation of the content and appearance of the technology was carried out through two Delphi rounds, and in Round I, seven items obtained an agreement rate below the cutoff point (<0.70). At the end of Round II, the technology was described by the title “Nursing process for patients with pressure injuries in the ICU (PELeICU)”, comprising five domains, corresponding to the stages of the Nursing Process, and 89 items. Of the five domains, three obtained maximum agreement in all items evaluated. Only one item from domain II had a moderate agreement rate. The appearance of the technology also obtained maximum agreement. In accordance with what has been exposed, it is believed that the use of the technological product constructed and validated in this study can contribute to the optimization of the time spent on nursing care, as well as favoring an effective articulation between the multiprofessional team, an adequate support for pressure injury management and management of indicators related to these conditions.