Qualidade da assistência de enfermagem : práticas seguras no manuseio do cateter vascular central

• Autor(a) principal: Oliveira, Júlian Katrin Albuquerque de
• Data de Publicação: 2016
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UFS
• Texto Completo: https://ri.ufs.br/handle/riufs/4986
• topic: Enfermagem; Cuidados de enfermagem; Qualidade da assistência à saúde; Cateteres venosos centrais; Avaliação da qualidade dos cuidados de saúde; Nursing care; Quality assurance; Health care; Central venous catheters; CIENCIAS DA SAUDE::ENFERMAGEM

This study aimed to evaluate the conformity of care practice of nursing staff in handling the central vascular catheter. This is a descriptive, prospective, observational study in the Intensive Care Unit of a reference hospital in the state of Sergipe. Data collection occurred from January to March 2016, in three shifts, from direct and structured observation of procedures involving the manipulation of central vascular catheter. The sample was not probabilistic, intentional and consisted of three procedures watching opportunities performed by nursing staff administering medication, changing needleless components and dressing change. For data analysis we calculated the overall compliance rates and specific from the recommended process indicators by ANVISA, subject to a stated Positivity Index (PI) equal to or greater than 80%, which corresponds to safe care. They were also made associations between variables (professional category, shift and sex) and the three observed procedures (medication administration, exchange equipo and dressing change) from the chi-square test and Fisher exact test, adopting a level of 5% significance. The project was approved by the Ethics Committee of the Federal University of Sergipe and nursing professionals signed the consent form consenting to observe its practices. 912 observations were made care involving the manipulation of the central venous catheter 378 (41.4%) observations of drug administrations, 267 (29.3%) of staff changes and 267 (29.3%) of dressings . 72 professionals were observed, most female 54 (72%). Of the total of professionals 55 (76%) were nursing technicians and 17 (24%) were nurses, distributed between the morning shift, 16 (22%), in the afternoon, 13 (18%) and night, 43 (60 %). The desired overall compliance has not been achieved in the three procedures observed, indicating a classified assistance as unwanted. As regards the administration of drugs, 3 (33%) observed actions reached specific line desired by the study, exchanging mans, 2 (25%) and dressing change, 8 (72%) shares have greater than or equal accordance 80%. Actions involving hand hygiene before aseptic procedure had lower specific compliance rate in the three procedures. When the variables associated work shift and sex of the nursing professional to assessed procedures, the night shift and the male nurses had most actions accordingly. There was no difference between the professional categories Nurse and Technician Nursing. It was evident that the conformity of the observed procedures are less than expected, demonstrating the importance of evaluation of work processes to improve care. The findings contribute to the development of educational strategies to ensure improved care practices, correcting the vulnerabilities found in the study.