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Healthcare Technologies Used in Nursing to Care for Polytraumatized Patients: an Integrative Review

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Healthcare Technologies Used in Nursing to Care for Polytraumatized Patients: an Integrative Review HEALTHCARE TECHNOLOGIES USED IN NURSING TO CARE FOR POLYTRAUMATIZED PATIENTS: AN INTEGRATIVE REVIEW Virna Ribeiro Feitosa Cestari1, Luís Rafael Leite Sampaio2, Islene Victor Barbosa2, Rita Mônica Borges Studart2, Bruna Bárbara Fernandes Moura1, Ana Rachel Cavalcante Araújo3 1Nursing undergraduate. University of Fortaleza. Fortaleza, Ceará, Brazil. 2Nurse. Doctor in Nursing. Professor at the Department of Nursing of the University of Fortaleza. Fortaleza, Ceará, Brazil. 3Nurse. Specialist in Intensive Care Nursing. State University of Ceará. Fortaleza, Ceará, Brazil. ABSTRACT: The aim of this study was to identify healthcare technologies used by nurses in the care for polytraumatized patients. This is an integrative review, with articles found in three databases in the period from May to July 2014. Nineteen articles from the period between 2009 and 2014 were selected and distributed among the three categories of healthcare technology: soft, soft-hard and hard. It was found that nursing workers adopted the three types of healthcare technology when caring for polytraumatized patients, emphasizing the soft-hard category. Soft technologies included health support and education of patient and family members/caregivers and training of the nursing team; soft-hard technologies: care management, admission of patients under risk, assessment and treatment of pain, nursing process and development of protocols; and hard technologies: information systems. Care improvements caused by healthcare technologies were found, since they reach all aspects of care. DESCRIPTORS: Prehospital care; Multiple trauma; Nursing care; Emergency nursing. TECNOLOGIAS DO CUIDADO UTILIZADAS PELA TECNOLOGÍAS DEL CUIDADO UTILIZADAS POR ENFERMAGEM NA ASSISTÊNCIA AO PACIENTE LA ENFERMERÍA EN LA ASISTENCIA AL PACIENTE POLITRAUMATIZADO: REVISÃO INTEGRATIVA POLITRAUMATIZADO: REVISIÓN INTEGRATIVA RESUMO: Objetivou-se identificar as tecnologias do cuidado RESUMEN: El objetivo del estudio fue identificar las utilizadas pelo enfermeiro na assistência ao paciente tecnologías del cuidado utilizadas por el enfermero en la politraumatizado. Revisão integrativa, com busca de artigos asistencia al paciente politraumatizado. Revisión integrativa, em três bases de dados, no período de maio a julho de 2014. cuya búsqueda de artículos ocurrió en tres bases de datos, Foram selecionados 19 artigos, compreendidos no período en el periodo de mayo a julio de 2014. Fueron seleccionados de 2009 a 2014, distribuídos nas três categorias tecnológicas 19 artículos, comprendidos en el periodo de 2009 a 2014, do cuidado: leves, leve-duras e duras. Verificou-se que distribuidos en las tres categorías tecnológicas de cuidado: os profissionais de enfermagem utilizam os três tipos leves, leve-duras y duras. Se verificó que los profesionales de de tecnologias do cuidado na assistência ao paciente enfermería utilizan los tres tipos de tecnologías del cuidado politraumatizado, com ênfase às leve-duras. Entre as en la asistencia al paciente politraumatizado, con énfasis a las tecnologias leves: apoio e educação em saúde do paciente leve-duras. Entre las tecnologías leves: apoyo y educación en e familiares/cuidadores e a capacitação da equipe de salud del paciente y familiares/cuidadores y la capacitación enfermagem; tecnologias leve-duras: gerência do cuidado, del equipo de enfermería; tecnologías leve-duras: gerencia acolhimento do paciente com classificação de risco, avaliação del cuidado, acojimiento del paciente con clasificación e tratamento da dor, processo de enfermagem e elaboração de riesgo, evaluación y tratamiento del dolor, proceso de de protocolos; e tecnologias duras: sistemas de informação. enfermería y elaboración de protocolos; y tecnologías duras: Percebeu-se a melhoria assistencial proporcionada pelas sistemas de información. Se percibió la mejoría asistencial tecnologias do cuidado, por estas abrangerem todos os proporcionada por las tecnologías del cuidado, a causa de aspectos do cuidar. que estas abarcan todos los aspectos del cuidar. DESCRITORES: Assistência pré-hospitalar; Traumatismo DESCRIPTORES: Asistencia prehospitalar; Traumatismo múltiplo; Cuidados de enfermagem; Enfermagem em múltiplo; Cuidados de enfermería; Enfermería en emergencia. emergência. Corresponding author: Received: 12/04/2015 Virna Ribeiro Feitosa Cestari Finalized: 24/07/2015 Universidade de Fortaleza R. Núbia Barrocas, 1280 - 60821-770 - Fortaleza, CE, Brasil E-mail: [email protected] Cogitare Enferm. 2015 Oct/dec; 20(4): 697-705 697 INTRODUCTION these three dimensions of technologies, which are determinants for care quality(9). Polytraumatism is result of traumatic events A search was performed for nursing in which there is a high displacement of force, publications involving the use of healthcare such as falls, traffic accidents, pedestrian crashes technologies on this clientele after contemplating and gunshot wounds, among other causes that the nurses’ responsibilities toward trauma patients result in serious lesions(1). It is considered the and knowing the complexities and specificities main cause of death among individuals in the age of the care dedicated to these individuals, who group of 20 to 40 years old, in other words, in the increasingly demand attention from nurses. individuals’ most productive years. For the most part, victims are male. Polytraumatism incidence This study is relevant for urgency and has been a cause of concern for researchers and emergency nursing because it subsidizes clinical administrators, due to the economic and social practice and evidences the need to reconstruct a impacts they generate(2). care model aimed at the care for polytraumatized patients in all aspects. Its aim is also to disseminate Trauma-related lesions may cause physical and/ scientific production that is available for assessing or mental disabilities, which can be temporary options and decision making when caring for or permanent, and also lead to death(3). Trauma these patients through technology applicability. victims go through a painful process, which involves confusion, fear of the unknown and fear Based on this reality, the aim of this study of facing death, mutilation, immobilization and was to identify healthcare technologies used by other changes in their identity and bodily integrity nurses in the care for polytraumatized patients. resulting from trauma, which can also affect their self-care capacity(4). METHOD The need to individualize care is felt by all workers that take part in these cases due to the This study consists of an integrative literature many types of presentation, status and complexity review, a method that aims to synthesize results of trauma(5). Nurses have crucial roles in caring obtained from studies on a certain theme or for trauma victims since, as coordinators of the issue in a systematic, orderly and wide-ranging nursing team, they must define and prioritize care way through the careful observation of six that is to be administered and establish preventive stages: identification of the research subject; and healing measures in a scenario where the definition of characteristics of primary research time between life and death is short(6). For that on the theme; selection, by peers, of studies that end, we highlight the importance of technology composed the sample; analysis of findings from production for innovation in the healthcare and the articles; interpretation of results and report of nursing fields, because it promotes organization the review, which enables a critical examination (10) of the service, the types of care and supports and of the findings . (7) innovates professional performance . This review was guided by the following Healthcare technologies are divided in hard, question: Which healthcare technologies soft-hard and soft. Hard technology, or dead labor, have been used by nurses in the care for refers to the complex instruments in general, polytraumatized patients? including all treatment hardware, exams and The search took place in the period from May organization of information; soft-hard refers to until June 2014, using the following databases: professional knowledge, well-adjusted to clinic, Latin-American and Caribbean Literature on epidemiology and the other professionals that Health Sciences (LILACS), Scientific Electronic compose the team. Soft technologies are those Library Online (SciELO) and Nursing Database used in human relations, such as the creation (BDENF), based on the following health science of rapport, autonomization, and triage, in the descriptors: “multiple trauma”, “emergency encounter between the professional and the and nursing” and “nursing care”. The search equation (8) user/patient . was (“multiple trauma” AND “emergency Understanding emergency nursing care nursing”) OR (“multiple trauma” AND “nursing from the perspective of technologies enables care”). the construction of accountability, reliability, Inclusion criteria for publications chosen relations of rapport and triage. In this perspective, for the study were: articles that addressed the nursing care must seek the harmonization of proposed goal; which were indexed in the 698 Cogitare Enferm. 2015 Oct/dec; 20(4): 697-705 LILACS, SciELO and BDENF databases; published longitudinal studies; level V – evidence from between 2009 and 2014; in Portuguese, English descriptive studies(11). and Spanish; and electronically available in full; Editorials, letters to the editors, works published RESULTS in event annals, reflection papers and duplicate publications were excluded.
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