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Redalyc.Neonatal Nursing Care of the Infant with Congenital Heart Disease Online Brazilian Journal of Nursing E-ISSN: 1676-4285 [email protected] Universidade Federal Fluminense Brasil da Silveira Magalhães, Simone; Veraci Oliveira Queiroz, Maria; Camelo Chaves, Edna Maria Neonatal nursing care of the infant with congenital heart disease: an integrative review Online Brazilian Journal of Nursing, vol. 15, núm. 4, 2016, pp. 724-734 Universidade Federal Fluminense Rio de Janeiro, Brasil Available in: http://www.redalyc.org/articulo.oa?id=361453980016 How to cite Complete issue Scientific Information System More information about this article Network of Scientific Journals from Latin America, the Caribbean, Spain and Portugal Journal's homepage in redalyc.org Non-profit academic project, developed under the open access initiative ISSN: 1676-4285 Neonatal nursing care of the infant with congenital heart disease: an integrative review Simone da Silveira Magalhães1,2, Maria Veraci Oliveira Queiroz1, Edna Maria Camelo Chaves1 1 State University of Ceará 2 Walter Cantídio University Hospital ABSTRACT Aim: To search for available evidence in the literature about nursing care for newborns with congenital heart disease in neonatal units. Method: An integrative review of the literature performed between July and August 2015, based on research in LILACS, PubMed and CINAHL databases. Result: Nine articles were identified according to established criteria. The information was analyzed and synthesized in three thematic categories: Detecting congenital heart disease; Providing care for the neonate in the intensive care unit; Family and the care measures to the newborn. Discussion: Neonatal screening for critical heart defects by pulse oximetry and nursing care at bedside surgeries were the main health care measures of nurses for infants with neonatal heart disease. Conclusion: There is a need for more professional involvement in the provision of care for these children in order to provide evidence-based clinical practice, and there are gaps in nurses’ knowledge production that demonstrate this reality. Descriptors: Heart Defects, Congenital; Nursing Care; Neonatal Nursing; Infant, Newborn. Magalhães SS, Queiroz MVO, Chaves EMC. Neonatal nursing care of the infant with congenital heart disease: an integrative 724 review. Online braz j nurs [internet] 2016 Dec [cited year month day]; 15 (4):724-734. Available from: http://www.objnursing. uff.br/index.php/nursing/article/view/5415 INTRODUCTION tion during clinical practice with children with congenital heart diseases, using an innovative Cardiac malformations are the most fre- methodology supported by scientific evidence. quent occurrence of all congenital malforma- Integrative review is one of the methods used tions. The prevalence of congenital cardiopa- in EBP that allows the incorporation of evidence thies in Brazil in 2009 was 675,495 children and into clinical practice. This study aimed to find the adolescents, in addition to 552,092 adults. In evidence available in the literature on nursing every 1000 infants, approximately one to two care for newborns with congenital heart disease, present a potentially fatal cardiac issue, usually in the neonatal unit, with a focus on providing because both systemic and pulmonary blood resources for clinical practice and directions for flow depend on a patent ductus arteriosus(1,2). further research. Congenital heart conditions account for 24% of infant deaths and approximately 4,800 chil- dren are born each year with one of the seven METHOD critical congenital heart diseases(3). However, infants with critical heart disease may remain An integrative review is a research method asymptomatic for the first few days of life and capable of synthesizing the results of previous be discharged from hospital, and their health research on a given phenomenon through a can deteriorate rapidly at home. Therefore, early systematic and summarized analysis of the lite- diagnosis in a timely manner is fundamental to rature. It enables the identification of knowled- improve prognosis and reduce morbidity and ge gaps in relation to the phenomenon under mortality rates in these cases(4,5). study and the need for future studies in the Considering that congenital heart diseases area(8). According to the method, the research are anomalies that determine the life and deve- followed these steps: Elaboration of the resear- lopment of the children, and also that nursing ch guiding question; Research in the literature is included in all stages of the process of health of primary studies based on the inclusion and care for babies with heart disease, even in non- exclusion criteria; Sorting of the pre-selected -specialized units such as the neonatal unit, there studies (extraction of data from primary studies); is a need to improve the clinical practice of these Critical analysis of the primary studies selected; professionals so that they can provide safe and Analysis and synthesis of the evaluated results; evidence-based care measures. Integration review(9). Studies show that evidence-based practice Considering the high prevalence of conge- (EBP) raises quality levels in the provision of care, nital cardiopathies in neonatal units, especially improves patient outcomes, reduces costs, and among preterm infants, and the fact that the brings greater satisfaction to nurses, although it is provision of care to these newborns presents not as yet a practice implemented in many health a challenge for nurses, the following question systems around the world(6). EBP is a movement was elaborated: “What evidence is available in that seeks to link theory to practice with the goal the literature about the nursing care provided of gathering, applying and evaluating the best to newborns with congenital heart defects in research results for safe clinical practice(7). neonatal units?” In order to carry out the rese- In order to fill nursing training gaps, it is arch in the articles published between July and expected that there will be continuing educa- August 2015, we used the following databases, Magalhães SS, Queiroz MVO, Chaves EMC. Neonatal nursing care of the infant with congenital heart disease: an integrative review. Online braz j nurs [internet] 2016 Dec [cited year month day]; 15 (4):724-734. Available from: http://www.objnursing. 725 uff.br/index.php/nursing/article/view/5415 accessed through the Portal of Journals of the articles with no participation of nurses in the Coordination of Improvement of Higher Edu- research, and those published before February cation Personnel (CAPES): Latin American and 2004. Duplicated studies were also excluded in Caribbean Literature of Health Sciences (LILACS), the selection of articles. To make the selection, which comprises publications in the area of heal- we read the articles’ titles and abstracts, as well th in Latin America and the Caribbean; National as some complete texts, in order to determine Library of Medicine of the National Institutes of whether they covered the research question Health (PubMed), a digital archive produced by and met the inclusion or exclusion criteria. The the National Library of Medicine (USA) in the search resulted in 470 eligible studies. After the Biosciences field; Cumulative Index to Nursing first reading and application of the inclusion and Allied Health Literature (CINAHL), which and exclusion criteria, 25 studies were selected. contains the main scientific publications in the After the second reading, however, only nine nursing area. Keywords and descriptors were were selected as the final sample of the review. used according to the Health Sciences Descrip- Of the total search, 57 studies were not related tors (DeCS) and the Medical Subject Headings to the theme, three were editorials, nine were (MESH), used in different combinations with repeated in the databases, 341 had no complete the following Portuguese and English Boolean texts available, in three there was no participa- operators: recém-nascido, neonato, cardiopatias tion of nurses in the research, 31 were out of the congênitas, unidades de terapia intensiva neo- timeframe, five were letters to the editor, seven natal, unidade neonatal, neonatologia, cuidados were review studies, four were case studies, and de enfermagem, infant, newborn, neonate, one was published in Spanish. The first three congenital heart defects, heart abnormalities, steps of the review are summarized in Figure 1. malformation of heart, neonatal intensive care Data extraction and analysis were carried units, nursing care. out through an adapted instrument that ad- In the selection of the literature, we applied dressed the identification of the article and its the following inclusion criteria: articles with authors, year and country of publication, study complete texts available, published in Portu- institution, publication journal and methodologi- guese and English, addressing questions related cal characteristics of the study (type of research, to the topic or answering the research guiding its question or goal, sample, data treatment, question, and articles involving the participation interventions performed, results, analysis, impli- of nurses. It was important to include studies cations/conclusions, authors’ recommendations carried out after February 2004 due to the publi- and evidence level), and also method precision cation of Ministerial Order No. 198 of the Ministry evaluation. The information was analyzed and of Health, which established the National Policy synthesized in thematic categories through the of Permanent Education in Health as a strategy
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