Sônia Maria Josino dos Santos

Competence of nurses in pre-hospital urgencies and emergencies: integrative review

Objective: to evaluate the scientific evidence about the skills of nurses in Pre-hospital attendance. Method: integrative review, with search in the databases LILACS, MEDLINE and SCOPUS, studies among 2002 to 2012. For that, the question was elaborated << Which are the evidence about the skills of nurses for the prehospital care? >>. After the selection of studies, they were read in their entirety and, then, the data were extracted and organized for analysis into categories. Results: it was found the managerial, technical/care, educational, cognoscitive and interactional. The competence, in the context of practice of nurses, showed different significations: own function of professional and ability to perform the task with quality, knowledge, experience, as well as personal values. Conclusion: the abilities identified in each competence are important insofar as they contribute to the clarification of the elements and strategies of nurses to respond better to the needs inherent to each competence in the pre-hospital Care. Descriptors: Clinical Competence; Professional Competence; Nursing in emergency; Nursing. RESUMO Objetivo: avaliar as evidências científicas acerca das competências de enfermeiros no Atendimento Préhospitalar. Método: revisão integrativa, com busca nas bases de dados LILACS, MEDLINE e SCOPUS, de estudos entre 2002 a 2012. Para isso, foi elaborada a questão << Quais as evidências sobre as competências do enfermeiro para o atendimento pré-hospitalar? >>. Após a seleção dos estudos, procedeu-se com a leitura na íntegra e, em seguida, os dados foram extraídos e organizados para a análise em categorias. Resultados: foram encontradas a competência gerencial, técnica\assistencial, educativa, cognoscitiva e interacional. As competências, no contexto de atuação do enfermeiro, mostraram diferentes significações: função própria de profissional e capacidade para desempenhar a tarefa com qualidade, conhecimento, experiência, assim como valores pessoais. Conclusão: as habilidades identificadas em cada competência são importantes na medida em que contribuem para a clarificação dos elementos e estratégias de enfermeiros para responder melhor às necessidades inerentes a cada competência no Atendimento Pré-hospitalar. Descritores: Competência Clínica; Competência Profissional; Enfermagem em Emergência; Enfermagem. RESUMEN Objetivo: evaluar las evidencias científicas acerca de las competencias de enfermeros en la Atención Prehospitalaria. Método: revisión integrativa, con búsqueda en las bases de datos LILACS, MEDLINE y SCOPUS, de estudios entre 2002 a 2012. Para eso, fue elaborada la pregunta << ¿Cuáles son las evidencias sobre las competencias del enfermero para la atención pre-hospitalaria? >>. Después de la selección de los estudios, se procedió con la lectura en su íntegra y, en seguida, los datos fueron extraídos y organizados para el análisis en categorías. Resultados: fueron encontradas la competencia gerencial, técnica\asistencial, educativa, cognoscitiva e interaccional. Las competencias, en el contexto de actuación del enfermero, mostraron diferentes significaciones: función propia del profesional y capacidad para desempeñar la tarea con calidad, conocimiento, experiencia, así como valores personales. Conclusión: las habilidades identificadas en cada competencia son importantes en la medida en que contribuyen para la clarificación de los elementos y estrategias de enfermeros para responder mejor las necesidades inherentes a cada competencia en la Atención Pre-hospitalaria. Palabras clave: Competencia Clínica; Competencia Profesional; Enfermería en emergencia; Enfermería. Nurse, Doctorate in Nursing, Federal University of Ceará/UFC. Teacher, Nursing Core, Federal University of Pernambuco/Academic Center of Vitória/UFPE-CAV. Vitória de Santo Antão (PE), Brazil. E-mail: smjosino@gmail.com; Nurse, Doctorate in Nursing, Nursing Department / PostGraduate Program in Nursing, Federal University of Ceará/PPGENF/UFC. Fortaleza (CE), Brazil. E-mail: anakarinaufc@hotmail.com; Nurse, Doctorate in Nursing, Professor, Nursing Department / Post-Graduate in Nursing, Federal University of Ceará/PPGENF/UFC. Fortaleza (CE), Brazil. E-mail: thelmaaraujo2003@yahoo.com.br; Nurse, Doctorate in Nursing, Federal University do Ceará/UFC. Professor, Nursing Core, Federal University of Pernambuco/ Academic Center of Vitória/UFPE-CAV. Vitória de Santo Antão (PE), Brazil. E-mail: elianerolim@yahoo.com.br; Nurse, Doctorate in Nursing, Federal University of Ceará/UFC. Professor, Nursing Core, Federal University of Pernambuco/ Academic Center of Vitória/UFPE-CAV. Vitória de Santo Antão (PE), Brazil. E-mail: souza_mariaamelia@hotmail.com; nurse, Doctorate in Nursing, Federal University of Ceará/UFC. Professor, Nursing Core, Federal University of Pernambuco/ Academic Center of Vitória/UFPE-CAV. Vitória de Santo Antão (PE), Brasil. E-mail: vivi_rolim@yahoo.com.br ARTICLE INTEGRATIVE REVIEW Santos SMJ dos, Pinheiro AKB, Araújo TL de et al. Competence of nurses in pre-hospital... English/Portuguese J Nurs UFPE on line., Recife, 7(11):6515-23, Nov., 2013 6516 DOI: 10.5205/reuol.3794-32322-1-ED.0711201326 ISSN: 1981-8963 Pre-hospital emergency configures itself as risk factors of life when the service is not performed in time and appropriate procedures are not carried out. The rapid and effective assessment of severity at the accident place may represent a chance of survival for victim to the arrival at the hospital; therefore, there is a need for training of health professionals to act in Pre-hospital Care (PHC). The Emergency Mobile Service (SAMU) was deployed in Brazil in September 2003 and is an important component of health care, being one of the areas of expertise of nurses, whose purpose is to serve as early, and appropriately, the urgencies and emergencies that have occurred in out-hospital environments. In Brazil, from the decade of 1980s, it was given emphasis in the training of nurses operating in emergency care and, in 2002, it was regulated and normalized the PreHospital Care (PHC), defining competencies of the team that operates this service. The competence is in the legal bases for making actions on construction of human resources training policy, establishing as one of the tasks of the Unique Health Unit (SUS) the ordering of human resources training. In this sense, qualification requirements and productivity of health care professionals to meet the changes quickly in economic, political social and cultural contexts have been seen; what extends the eligibility requirements of workers, making increasingly required the deployment of training models and competences based management. The concept of competence is not new dating back for centuries, probably since the time of apprentices to craftsmen in the middle ages and the evolution of this concept, as well as from its use by the human resources area, has been much debated. The definition of professional competency and training and qualification based in competences emerged in the years of 1960s, in the United States, and years of 1980s in England. Thus, it was conceived as the quality of who is able to appreciate and solve particular subject, carry out activity and ability to meet the personal and professional needs in the most varied contexts of services. The formation of nursing workers in Brazil adopts the perspective of vocational competences anchored in a criticalemancipatory approach, with appreciation of diversity and aspects related to the practice and its specificities, whose different production units in health care must be considered and based on the fundamentals of the SUS. The Ministry of health (MS), through the Emergency Education Cores (NEU), proposes broad training and qualification process for the regulation of health professionals within the SUS, and as a way to maintain and increase the autonomy of individuals, comes to implement the strategy for the promotion of quality of life as a way of confronting the causes of emergencies. This strategy seeks to enhance the prevention of harm and protection of life, generating change in welfare perspective – focused on the consequences of damages that generate emergency – to aspire to the integral and integrated vision, totalizing approach and seek to generate autonomy for individuals and collectivities. So, it should be included in health promotion strategy, protection of life, health education and the prevention of harm and diseases, in addition to new meaning to care and rehabilitation. The nurses are constantly asked to assume roles in nursing care and that the challenges to seek knowledge in order to improve actions for health promotion. The insertion of the nurse in pre-hospital care is not new, since there have been reports of the presence of this professional in the care of the wounded in big wars, however, in Brazil, this evidence occurred only from the early 1990s, when structuring the attendance to the urgencies/emergencies wins new focus. In this context and with the purpose of contributing to the nursing for delimitation of attribution at PHC, justifies the need to conduct studies that reflect the competencies of nurses to Pre-hospital Care (PHC). Given the context presented, it aims: ● to assess the scientific evidence about the competences of nurses in Pre-hospital Care. It was used the methodology proposed by the integrative review, method used in evidence based practice that makes it possible to gather and synthesize results of studies on particular issue. Six phases were used: identification of the subject or problem definition and elaboration of the guiding question for the research; establishment of criteria for inclusion of articles (sample selection); definition of the information to be extracted from selected articles; evaluation of selected studies; analysis and interpretation of results; and presentation of results. METHOD INTRODUCTION Santos SMJ dos, Pinheiro AKB, Araújo TL de et al. Competenc