La práctica interprofesional en el Servicio de Emergencia: asignaciones específicas y compartidas de los enfermeros

Batista, Ruth Ester Assayag; Peduzzi, Marina

doi:10.1590/0034-7167-2017-0797

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Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 72 (suppl 1) • Feb 2019 • https://doi.org/10.1590/0034-7167-2017-0797 copiar

La práctica interprofesional en el Servicio de Emergencia: asignaciones específicas y compartidas de los enfermeros

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

Mapear y categorizar de acuerdo con la Clasificación de las Intervenciones de Enfermería las atribuciones específicas de los enfermeros e identificar las compartidas con médicos y fisioterapeutas en el Servicio de Emergencia.

Método:

Estudio exploratorio descriptivo, realizado en dos fases: la primera constituida por análisis de disertaciones/tesis de la base de datos del Centro de Estudios e Investigaciones de la Asociación Brasileña de Enfermería (Centro de Estudos e Pesquisas da Associação Brasileira de Enfermagem). En la segunda, fue utilizada la Técnica Delphi para obtener consenso sobre cuáles atribuciones eran específicas de los enfermeros y cuáles eran compartidas con fisioterapeutas y médicos.

Resultados:

45,7% específicas de los enfermeros; 14,2% compartidas con fisioterapeutas y/o médicos; y en 40% (n = 42) no hubo consenso sobre el reparto de las atribuciones.

Conclusión:

El intercambio de acciones entre los profesionales muestra la ampliación del alcance de la práctica de las profesiones y la constitución de una esfera común de trabajo, pero el elevado número de atribuciones sin consenso entre los especialistas puede ser un área de potenciales conflictos por la indefinición de las atribuciones.

Descriptores:
Relaciones Interprofesionales; Equipo de Asistencia al Paciente; Comportamiento Cooperativo; Enfermería; Servicio de Emergencia

Sharing of activities	n	%
With no consensus	42	40.00
Specific of nurses	48	45.70
Shared with physiotherapist	1	0.97
Shared with doctors	12	11.40
Shared with doctors and physiotherapist	2	1.93
Total	105	100

Assignments specific of nurses
1) 0466 - Enema administration: Instillation of a solution in the lower gastrointestinal tract.
2) 0590 - Control of Urinary Elimination: Management of an excellent standard of urinary elimination.
3) 0840 - Positioning: Deliberately drive a patient or body part to promote physiological and/or psychological well-being.
4) 1080 Gastrointestinal catheterization: Insertion of a tube into the gastrointestinal tract.
4) 1080 - Gastrointestinal catheterization care: Management of patient with gastrointestinal catheter.
6) 1056 - Enteral feeding tubes: Supply of nutrients and water through a gastrointestinal catheter.
7) 1050 - Feeding: Providing nutritional intake for patients who are unable to feed themselves.
8) 1610 - Bath: Clean the body for the purpose of relaxation, cleanliness and recovery.
9) 1630 - Dress: Choice, placing and removal of clothes of a person who can not do it alone.
10) 1720 - Promotion of Oral Health: Promotion of oral hygiene and dental care for the patient with normal oral and general health.
11) 2300 - Medicines administration: Prepare, administer and evaluate the efficacy of prescription and over-the-counter medicines.
12) 2314 - Intravenous medication administration (IV): Preparation and administration of medication into the vein.
13) 3520 - Pressure ulcers care: Facilitating the healing of pressure ulcers.
14) 3660 - Wound care: Prevention of complications and promotion of wound healing.
15) 2930 - Surgical preparation: Providing care for the patient immediately before surgery and confirmation of required procedures/tests and documentation in the clinical record.
16) 4030 - Hemoderivative administration: Administration of blood or hemoderivatives and monitoring of the patient's reaction.
17) 4200 - Intravenous therapy: Administration and monitoring of fluids and intravenous medicines.
18) 4238 - Vessel puncture: venous blood sample - Collection of venous blood sample from a non-cannulated vein.
19) 5602 - Teaching: disease process - Care for the patient so they can understand information regarding a specific process of the disease.
20) 5618 - Teaching: procedure/treatment - Preparation of the patient to understand and be mentally prepare for prescribed procedure or treatment.
21) 6650 - Supervision: Continuous and purposeful acquisition, interpretation and synthesis of patient data for decision making.
22) 6480 - Control of the environment: Management of the environment of the patient for therapeutic benefit, sensory appeal and psychological well-being.
23) 7830 - Employee Supervision: Facilitation of offering highly skilled care for the patient by others.
24) 7722 - Preceptor: employee - Assistance and support to a new or transferred employee through a planned orientation to an specific clinic area.
25) 7840 - Supplies Control: Acquisition and management warranty of items suitable for providing patient care.
26) 7620 - Checking of controlled substances - Promotion of proper use and management of the security of controlled substances.
27) 7650 - Delegation: Transfer of responsibility for the conduct of patient care, while maintaining accountability for results.
28) 7710 - Support for the doctor: Collaboration with doctors to provide quality care for the patient.
29) 7726 - Preceptor: Student - Assistance and support for learning expectations for a student.
30) 7820 - Control of samples for exams - Obtaining, preparation and storage of samples for laboratory examination.
31) 7850 - Employee development: Development, management and monitoring of team competence.
32) 8100 - Referrals: Organization of services by other professional or institution.
33) 8060 - Transcript of prescriptions: Transfer of information from prescription sheets to nursing care planning and documentation system.
34) 8140 - Shift management: Exchange of essential information about patient care with another nursing team at switch of shift.
35) 3540 - Pressure ulcer prevention - Pressure ulcer prevention for an individual at high risk of developing ulcers.
36) Locate patient companion^* * Non-registered activity at Nursing Interventions Classification
37) Find professional cleaning^* * Non-registered activity at Nursing Interventions Classification
38) Register patient removal in specific worksheet^* * Non-registered activity at Nursing Interventions Classification
39) Separate and prepare medical records for hospitalization^* * Non-registered activity at Nursing Interventions Classification
40) Find doctor^* * Non-registered activity at Nursing Interventions Classification
41) Call for electrocardiogram (ask to refer patient)^* * Non-registered activity at Nursing Interventions Classification
42) Prepare monthly range of employees^* * Non-registered activity at Nursing Interventions Classification
43) Manage interpersonal relations; Manage the unit^* * Non-registered activity at Nursing Interventions Classification
44) Provide comprehensive and holistic care^* * Non-registered activity at Nursing Interventions Classification
45) Request the management of the institution's structures^* * Non-registered activity at Nursing Interventions Classification
46) Perform daily ranges of work^* * Non-registered activity at Nursing Interventions Classification
47) Manage the implementation of the prescribed diagnostic laboratory tests^* * Non-registered activity at Nursing Interventions Classification
48) Prepare and circulate the material on suture procedure room^* * Non-registered activity at Nursing Interventions Classification

Assignments shared with doctors
1) 0580 - Urinary catheterization: Insertion of a catheter in the bladder for temporary or permanent drainage of urine.
2) 1400 - Pain control: Pain relief or pain reduction up to a level of comfort that is acceptable to the patient.
3) 3120 - Insertion and stabilization of artificial airways: Insertion or insertion assistance and stabilization of an artificial airway.
4) 6362 - Triage: Catastrophe: Rank of patient care priorities for urgent treatment while scarce resources are allocated.
5) 6200 - Emergency care - Assessment and actions implementation to save life in urgent situations.
6) 6580 - Physical restraint - Application, monitoring and removal of mechanic or manual restraint used to limit the physical mobility of the patient.
7) 6430 - Chemical restraint - Administration, monitoring and discontinuation of psychotropic agents used to control extreme behavior of an individual.
8) 6680 - Vital signs monitoring: Collection and analysis of cardiovascular, respiratory and body temperature data to determine and prevent complications.
9) 7370 - Discharge plan: Arrangement for the transfer of a patient from one level of care to another, within the same health institution or to another location.
10) 2120 - Hyperglycemia control - Prevention and treatment of blood glucose levels above normal.
11) 2130 - Hypoglycemia control - Prevention and treatment of low blood glucose levels.
12) NCA - Conducting neurological evaluation.

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

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[1] Corresponding Author: Ruth Ester Assayag Batista E-mail: ruth.ester@unifesp.br