Melhoria da assistência neonatal: validação do subconjunto terminológico da CIPE® para o cuidado de recém-nascidos com cateter venoso central de inserção periférica

Abstract

As a fundamental component of intensive and specialized care, the Neonatal Intensive Care Unit (NICU) is configured as an environment designed for performing essential interventions and treatments for hospitalized neonates. Clinical practice in this context requires the execution of invasive procedures, among which the use of central venous catheters stands out. The Peripherally Inserted Central Catheter (PICC) is often the first choice for medium- to long-term treatment. PICC insertion is an advanced and complex procedure, and its management demands technical skills and clinical reasoning from nurses. This study aimed to clinically validate a Terminological Subset of the International Classification for Nursing Practice (CIPE®) for newborns with Peripherally Inserted Central Catheters in the Neonatal Intensive Care Unit, using Betty Neuman’s Systems Model as the theoretical framework. It is a prospective clinical validation study, carried out in the following stages: implementation of the Nursing Process in a medium-sized hospital in Northeastern Brazil; development of case studies; and concordance analysis among expert nurses. The Kappa concordance coefficient, Kruskal-Wallis test, and intraclass correlation coefficient (ICC) were used. The study was guided by the Standards for Quality Improvement Reporting Excellence (SQUIRE) from the Enhancing the Quality and Transparency of Health Research initiative. The sample consisted of 40 neonates hospitalized in the NICU using PICC. The study adhered to regulatory principles for research involving human subjects and was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, under approval number 7.171.001. The diagnoses/outcomes and interventions were evaluated with near-perfect/perfect agreement and excellent ICC. The Kruskal-Wallis test showed no significant differences among the evaluations. The study clinically validated a subset of 53 nursing diagnoses/outcomes and 110 nursing interventions, demonstrating its applicability in the care of neonates with Peripherally Inserted Central Catheters.