Amanda de Figueirôa Silva Carmo

Nurses perceptions about the use of equipment in the intensive care unit

Objective: to know the perception of intensive care nurses about the relationship between safety of care, humanity and the use of equipment in the work process. Method: exploratory and descriptive study, of qualitative approach, in Adult Intensive Care Unit. The study included six of the ten nurses located in the sector. Semi-structured interviews were used, individual and recorded treated by means of content analysis. The research project was approved by the Research Ethics Protocol 0003/240812. Results: positive and negative aspects of the use of equipments were identified. The correct handling showed dependent on previous educational experience, and preventive maintenance. The communication with the patient was critical for human assistance. Conclusion: to characterize and qualify the use of equipment in health is an important tool to ensure the safety and humanity of nursing care. Descriptors: Nursing; Intensive Care Units; Equipment. RESUMO Objetivo: conhecer a percepção de enfermeiros intensivistas acerca da relação entre segurança do cuidado, humanidade e o uso de equipamentos no processo de trabalho. Método: estudo exploratório e descritivo, de abordagem qualitativa, em Unidade de Terapia Intensiva Adulto. Participaram do estudo seis dos dez enfermeiros lotados no setor. Utilizou-se de entrevistas semiestruturadas, individuais e gravadas, tratadas por meio da análise de conteúdo. O projeto de pesquisa foi aprovado pelo Comitê de Ética em Pesquisa, Protocolo 0003/240812. Resultados: foram identificados aspectos positivos e negativos do uso dos equipamentos. O correto manuseio mostrou-se dependente de experiência educacional anterior e de manutenção preventiva. A comunicação com o paciente mostrou-se fundamental para uma assistência humana. Conclusão: caracterizar e qualificar o uso dos equipamentos em saúde é uma importante ferramenta para garantir a segurança e a humanidade da assistência de enfermagem. Descritores: Enfermagem; Unidades de Terapia Intensiva; Equipamento. RESUMEN Objetivo: conocer la percepción de los enfermeros de cuidados intensivos sobre la relación entre la seguridad de la atención, la humanidad y el uso de equipamientos en el proceso de trabajo. Método: estudio exploratorio y descriptivo, con enfoque cualitativo, en Unidad de Terapia Intensiva en Adultos. Participaron del estudio seis de los diez enfermeros localizados en el sector. Se utilizaron entrevistas semi-estructuradas, individuales y grabadas, tratadas por medio de análisis de contenido. El proyecto de investigación fue aprobado por el Comité de Ética e Investigación, Protocolo 0003/240812. Resultados: fueron identificados aspectos positivos y negativos de la utilización de los equipamientos. El manejo correcto dependía de la experiencia educativa previa, y del mantenimiento preventivo. La comunicación con el paciente se mostró fundamental para una asistencia humana. Conclusión: caracterizar y cualificar el uso de los equipamientos de salud es una herramienta importante para garantizar la seguridad y la humanidad de los cuidados de enfermería. Descriptores: Enfermería; Unidades de Cuidados Intensivos; Equipamiento. Nurse, Resident in Services Management of Nursing, University Hospital of Londrina, State University of Londrina/UEL. Londrina (PR), Brazil. Email: rodrigo.coelho.mendes@gmail.com; Nurse, Master Teacher in Mother and Child Health, Federal University of Vale do São Francisco/UNIVASF. Petrolina (PE), Brazil. Email: amandafigueiroa@gmail.com; Nurse, PhD in Fundamental Nursing, Nursing Department, State University of Londrina/UEL. Londrina (PR), Brazil. Email: carmohaddad@gmail.com; Nurse, Master Professor in Fundamental Nursing, Nursing Department, State University of Londrina/UEL. Londrina (PR), Brazil. Email: marianarossaneis@gmail.com ORIGINAL ARTICLE Mendes RNC, Carmo AFS, Haddad MCL et al. Nurses perceptions about the use of equipment... English/Portuguese J Nurs UFPE on line., Recife, 8(7):1904-11, July., 2014 1905 ISSN: 1981-8963 DOI: 10.5205/reuol.5963-51246-1-RV.0807201411 The health area, before simple, limited and somewhat safe, is complex, effective and potentially dangerous, due to the accumulation of knowledge and technology. Furthermore, it is perceptible that knowledge is produced fast, in an heterogeneous and unstructured manner, making Nursing to pass a difficult and constantly transition to ensure the safety and humanization of care, considering the growing symbiotic relationship between human cognition and informatics. This demand for technology is more pronounced in Intensive Care Units (ICUs), which are critical care environments for the admission of the most serious patients and are also dependent on advanced techniques and materials necessary for the diagnosis, monitoring and therapy. Oftentimes, the equipment exceeds the monitoring of clinical signs, being necessary its use for the life support as in the case of the mechanical ventilator. However, these units are recognized for providing care a relatively recent time, since they were initiated early in the second half of the twentieth century. This is a work environment that requires constant attention from nurses who are responsible, with a positive and realistic perception of themselves. It is observed that the work environment in ICUs, in the biomedical sense, is fragmented and tends to be overestimated, reflecting negatively about the human and holistic context of nursing care. And is not only so: the patients safety is also jeopardized when the confidence exacerbated in the machine becomes to overcome the human senses in the clinical judgment of the patient. This is because the comfort and saving time, enabled by the equipment, accommodate the professional. Discussions about the safety of care intensified after a publication of the Institute of Medicine (IOM) in Washington, a widespread internationally magazine, that estimated around 44 to 98 thousand annual deaths of Americans, as a result of errors in health. Since then, efforts to promote the safety of care were increasing. In Brazil, in 2010, the Brazilian Network of Nursing and Patient Safety (BRANETNPS) implanted from an initiative of the Pan American Health Organization (PAHO) in partnership with the Technical Board of the Regional Council of Nursing of São Paulo (RCONU SP) has published a booklet about the ten steps to patient safety and, among these, Safety in the Use of Technology. 6-8 This man-machine relationship can now be considered as cultural in ICUs, because is not conceived a critical unit without the support of implements and can also be cultural in other instances of assistance, because the technologies are increasingly developed and accessible in health services. No doubt, it will be a challenge to keep the care humane and effective and, especially safe with so many intermediaries. Therefore, the recent conviviality and increasingly intensified of nurses with the equipment in the care environment is constituted as a gap in nursing science, requiring the need for further discussions that measure and explore the impact of their use in productive relations of Nursing. This study aims to understand the perception of intensive nurses about the relationship between safety of care, humanization and use of equipment in their work process. Qualitative study with an exploratory and descriptive approach. The strategy was chosen due to the nature of the subject being well elucidated in the national literature. The descriptive qualitative research observes, describes and classifies the dimensions, the variations, the importance and significance of the phenomena. Also, when the exploratory character is added, its complex nature is investigated and the other factors to which the phenomenon is related. The survey was performed in one Intensive Care Unit (Adult) of a teaching hospital, located in the Northeast region of Brazil, which has 17 beds registered in the National Registry of Health Establishments (NRHE). The sample was not previously defined, because the criterion for saturation content was used. Thus, from ten clinical nurses located in the unit, seven were randomly approached, and one was excluded for not meeting the inclusion criterion, that was to have at least six months of work in the ICU, so, the content was satisfied with six professional. The production took place through semistructured interviews, individual and recorded with the assistance of a equipment MP3 portable player, using a previously established itinerary to guide the main theme of the interviews. To guide the research, the survey included the following guiding question << How intensive nurses perceive the relationship between the use of electronic METHOD INTRODUCTION Mendes RNC, Carmo AFS, Haddad MCL et al. Nurses perceptions about the use of equipment... English/Portuguese J Nurs UFPE on line., Recife, 8(7):1904-11, July., 2014 1906 ISSN: 1981-8963 DOI: 10.5205/reuol.5963-51246-1-RV.0807201411 equipment and safety and humanity of care? >>. The technique of Bardin was adopted, for content analysis of the interviews. The used technique involves that the analysis should observe some steps: pre-analysis choice of analysis body; exploration of the material which is the aggregation of data; and processing of data which highlights the information provided by the analysis. The technique can be systematized in steps: fluctuating reading; definition of provisional hypotheses; determination of registration units RU (words, phrases, news, etc.); marking of RU; definition of the meaning units (grouping of RU); thematic analysis of the RU; categorical analysis of the text; processing and presentation of the text; and discussion of results. The study was submitted to the Ethics Committee and Deontology in Studies and Research of the Federal University of Vale do São Francisco (ECDSR/UNIVASF), and was approved under the number 0003/240812. The respondents were asked about the minimal risks of psychological nature a