Segurança da criança hospitalizada em unidade de terapia intensiva: compreensão de pais e enfermeiros

• Autor(a) principal: Barbieri, Mayara Caroline
• Data de Publicação: 2020
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da UFSCAR
• Texto Completo: https://repositorio.ufscar.br/handle/ufscar/12881
• topic: Segurança do paciente; Criança hospitalizada; Família; Relações profissional-família; Qualidade da assistência à saúde/Qualidade dos cuidados de saúde; Enfermagem familiar; Recém-nascido; Patient safety; Hospitalized child; Family.; Professional-family relations; Quality of health assistance/Quality of health care; Family nursing; Newborn; CIENCIAS DA SAUDE::ENFERMAGEM

Researches on patient safety thematic have shown significant development. Nevertheless, it is still necessary to strengthen family involvement, which is essential for the security of hospitalized children. In this study, therefore, the objective was to develop a representative theoretical model of the insertion of parents in the security of hospitalized children, in the view of nurses and parents, being a qualitative, comprehensive research conducted in a tertiary hospital in the state of Paraná. The following references were selected: Symbolic Interactionism (theoretical) and Grounded Theory (methodological), both used for data collection, organization and analysis. The participants were recruited from the theoretical sampling in the neonatal and pediatric intensive care units, both references in the state under study. Data collection took place between January 2018 and December 2019, through audio-recorded semi-structured interviews and conversation circles, with the participation of 25 parents and 18 nurses working in the care units. The research was initiated after approval by the Human Research Ethics Committee. The process of analysis of the collected data obtained as a central theoretical model “seeking safe care and without harm”, which was divided into three categories (Experiencing the hospitalization of a child in ICU; (In)safety of parents of children in ICU; Facing complex and multifactorial processes) and their subcategories. Parents initially experience difficulties in the process of adaptation to the intensive environment, requiring the support of family, professionals, peers and spirituality. After the initial phase, they recognize the possibility of child care errors, and raise concerns about the child’s long-term quality of life. Parents recognize in the physical presence a determining factor for the inclusion in the child’s safety, since from this they can know their child, recognize warning signs, act in favor of their child’s safety and question professionals. Although the presence is decisive, it is necessary that professionals and family members establish partnership relations for this involvement to take place. Performing the care is recognized as an insertion aid tool. The presence of protocols and humanization are physical and organizational aspects that also interfere with the insertion of parents in child care and safety. Communication is valued, although full of challenges, such as the pursuit for the ideal moment to establish the relationship between parents and professionals and the transfer of information. Challenges such as workload, staff sizing, care sharing, vocational training and multiprofessional work influence the effectiveness of parents’ insertion in the safety of hospitalized children. It is concluded that parents and professionals seek to provide safe and without harm in care to children hospitalized in intensive care units. Inserting parents in the safety context is a complex factor and influenced by many variables, but, when effective, brings benefits to the relationship between professionals and parents, as well as reflexes in the improvement of child safety.