Descomplicando a ventilação mecânica invasiva: estratégia educacional para equipe multiprofissional de uma enfermaria pediátrica

Abstract

Children with certain chronic respiratory diseases commonly require hospitalization and, sometimes, invasive mechanical ventilation (IMV) for life support. Although IMV is a procedure customarily used in pediatric intensive care units, it is not frequent in pediatric wards. Some studies suggest that professionals who take care of mechanically ventilated patients have insecurities and gaps concerning the knowledge on this matter. Thus, the objective of this study was to implement an educational strategy for the teaching of IMV, focused on the learning needs of a multidisciplinary team in the pediatric ward of Onofre Lopes University Hospital. In order to achieve this purpose, this exploratory research of a qualitative nature, characterized as a Convergent Care Research, started by reviewing integrative literature on IMV teaching and its effects on the learning of health professionals. After that, four strategic steps were developed: (1) agreements in the unit; (2) convergence groups (CGs) for the identification of learning needs, which occurred from June through July of 2021. Thirty professionals distributed into seven CGs were interviewed through a semi-structured script. Then, the transcribed speeches were organized and systematized, which were exported to ATLAS.ti® version 9.0 software to be codified and categorized, according to Trentini and Paim’s (2004) analysis technique, which consists of apprehension, synthesis, and theorization. It was possible to identify six categories emerged from the data: needs for learning topics aligned with the context of care practice; need to understand the challenges of caring for the mechanically ventilated child; respect for previous repertoire; emphasis on predominantly manual educational activities; structural aspects for action planning; and importance of methodological approaches in the teaching-learning process. From that, the research proceeded to the steps of (3) planning and (4) carrying out the multidisciplinary training (MT), which occurred in August, September, October, and November of 2021. Fifteen nursing technicians, seventeen nurses, and twenty-one doctors participated in the MT. The results support that the CGs and MT promoted reflections upon care practices and provided an opportunity for a meaningful and problematizing learning experience, which stimulated the process of critical awareness of reality. This study contributed to the literature with two conceptual dimensions regarding the teaching-and-learning process of professionals in the researched context: (1) respect for the aspects of the reality experienced by the professionals, considering the participant's previous repertoire, and (2) the importance of collective participation in the construction of the MT, considering that it is possible to extract from the professionals themselves essential elements for an educational practice of complex health issues. This knowledge appeared in the pediatric ward in the form of technological productions, that is, the MT itself, and the supporting educational materials (ebooks and thematic games). The MT and the educational materials were only possible with the participation of the health professionals, and they appear as fruits of our work for scientific research and care practice, contributing to the qualification of care for mechanically ventilated children in nursing environments.