Protocolo de cuidados para redução de riscos de lesão por pressão em pacientes de uma unidade de terapia intensiva

Abstract

Currently, discussions about the importance of Patient Safety have gained great repercussions worldwide, this aims to work with six international goals, among them, the minimization of the risk of pressure injury stands out. Recent studies prove that the pressure injury rates in Intensive Care Units (ICU) can reach 50% of hospitalized patients. The Intensive Care Unit of the Municipal Hospital of Natal, in conjunction with the Ministry of Health, which gave the institution the opportunity to implement international patient safety goals, attributing to the ICU the pilot project to minimize the risk of pressure injury. Objective: The objective of this work is to build, together with the nurses of the adult ICU of the referred hospital, a Nursing Assistance Protocol related to the prevention of pressure injuries, aiming at patient safety. Methodology: The qualitative design was based on Convergent Care Research, based on an analysis of medical records to identify the Braden Scale scores applied to patients admitted to the reference ICU in the last year, in a second moment, semistructured interviews were conducted with ICU nurses. , referring to their knowledge on the subject in question, their needs and potential. The analysis of the empirical material took place through the Collective Subject Discourse and from this stage on, the construction of the Protocol began together with all nurses in the ICU, Patient Safety Center and Hospital Infection Control Commission in working groups. previously s. Results: Of the 177 patients admitted to the ICU in the evaluated hospital, 46.33% were female and 53.67% were male, with a mean age of 65.3 (± 16.50) years. The average length of stay for patients who developed PPL in the ICU was 14.51 days and for those who did not develop it, it was only 5.57 days. It was identified that the average score on admission of patients who developed LPP was 12.19 and those who did not develop LPP 13.47. Regarding the qualitative part of the study, the analysis of the testimonies was based on six questions, which resulted in nine CSDs. The responses were subdivided into “Category A” and “Category B” when two different types of responses were obtained. As a result, questions 1, 2 and 3 show CSD in categories A and B, while questions 4, 5 and 6 only have CSD in “Category A”. Conclusion: The results made it possible to trace the reality of the service studied, providing subsidies for planning the assistance provided and intensifying the understanding of the conditions experienced by nurses, pointing out difficulties and limitations in the prevention and treatment of PPL. The protocol was elaborated by the institution's own team aiming at standardizing the assistance provided to critically ill patients in order to reduce adverse events related to pressure injuries in the ICU.