Construcción de protocolo de cuidados de enfermería para niños después del trasplante de células tronco hematopoyéticas

Rodrigues, Jéssica Alline Pereira; Lacerda, Maria Ribeiro; Galvão, Cristina Maria; Gomes, Ingrid Meireles; Cubas, Marcia Regina; Fernandes, Ana Paula Pereira

Acessibilidade / Reportar erro

Brasil

Revista Gaúcha de Enfermagem

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Article • Rev. Gaúcha Enferm. 43 • 2022 • https://doi.org/10.1590/1983-1447.2022.20210028.en copiar

Construcción de protocolo de cuidados de enfermería para niños después del trasplante de células tronco hematopoyéticas

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

Construir un protocolo de cuidados de enfermería para niños después del trasplante de células tronco hematopoyéticas.

Método:

Investigación metodológica realizada entre enero y septiembre de 2019 para construir un protocolo, en tres etapas: a) realización de revisión integradora (fueron identificados cuidados de enfermería); b) estructuración y organización teórica de cuidados a partir de la Teoría de las Necesidades Humanas Básicas y de la Clasificación Internacional para la Práctica de Enfermería, complementando los datos de la revisión; y, c) desarrollo del protocolo, cuya elaboración integró las etapas anteriores. El análisis de comprensión de ítems/cuidados del protocolo fue realizado por tres enfermeras especialistas.

Resultados:

El protocolo de cuidados está compuesto por 40 problemas de enfermería y está organizado de acuerdo con las necesidades psicobiológicas, psicosociales y psicoespirituales de niños sometidos a trasplante, integrando cuidados prácticos y de orientación.

Conclusión:

El protocolo de cuidados es una opción tecnológica para la asistencia de enfermería al niño trasplantado, con los objetivos de prevención y manejo de las complicaciones del trasplante.

Palabras clave:
Investigación metodológica en enfermeira; Transplante de células madre hematopoyéticas; Diagnóstico de enfermería; Atención de enfermería; Niño; Terminología normalizada de enfermería

Universidade Federal do Rio Grande do Sul. Escola de Enfermagem Rua São Manoel, 963 -Campus da Saúde , 90.620-110 - Porto Alegre - RS - Brasil, Fone: (55 51) 3308-5242 / Fax: (55 51) 3308-5436 - Porto Alegre - RS - Brazil
E-mail: revista@enf.ufrgs.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Corresponding author:
Jéssica Alline Pereira Rodrigues E-mail: jessica.rodrigues@hc.ufpr.br

Basic Human Needs (TBHN)	Nursing problem	Basic human needs affected	(ICNP®) Code	Nursing Diagnoses (ICNP^®)	Nursing care (literature, ICNP^® and experience of specialist nurses)
PSICHOBIOLOGICAL
Regulation (cell growth and functional development)	Infection (viral, fungal, bacterial)	Regulation (thermal)	10023032	Infection	PRACTICAL CARE • Assess the persistence of fever and notify the physician; • Keep suspected or confirmed cases of respiratory infections in isolation and advise on the use of a mask; • Monitor vital signs, paying attention to temperature and clinical symptoms; • Perform physical examination; Administer antiviral, antifungal and/or antibiotic early, as prescribed by the physician; • Follow the recommended interval between prescribed doses of antivirals, antifungals and antibiotics. GUIDANCE CARE • Advise the caregiver on checking body temperature at home; • Advise the child and caregiver not to maintain contact with other patients if the viral infection is contagious; • Advise the child and caregiver on the importance of following the times of prescribed medications given by mouth; Reinforce the importance of body hygiene care to prevent infection; • Advise on the cleaning of the environment and the absence of contact with carpets, rugs, teddy bears, plants, animals, works; • Advise on the risk of fungal infection due to the use of immunosuppressants; • Reinforce the importance of a neutropenic diet, with cooked foods.

Basic Human Needs (TBHN)	Nursing problem	Basic human needs affected	(ICNP®) Code	Nursing Diagnoses (ICNP^®)	Nursing care (literature, ICNP^® and experience of specialist nurses)
PSICHOSOCIAL
Education for health and learning	Self-care/ Care provided by the caregiver	Gregarious communication, Recreation and leisure, Emotional security, Freedom and participation	10027773 10021788 10001647 10038411 10018410 10037230	Caregiver Stress; Stress due to Change (or Transfer) of the Environment; Social isolation; Mental disorder; Social disorder; Risk of Difficulty with Coping	PRACTICAL CARE • Assess the caregiver's ability to provide care; • Assess the child's and caregiver's psychosocial response to the care plan; • Discuss information from the internet capable of causing distress and/or confusion in the caregiver, not translating the reality of the transplantation process and generalizing the case; • Talk about shifting the role of the family; adjustment after isolation and hospitalization; common emotional responses; offering support; coping with life after treatment; • Offer motivational support; Help alleviate child and caregiver anxiety at the time of transition from different levels of care and locations, providing guidance for care; • Promote support for coping with the treatment to the child and caregiver; • Request support and involve the multidisciplinary team in care, including occupational therapy, psychology, social work; • Refer to psychiatric follow-up, if necessary; • Encourage support groups among caregivers, with monitoring by the multidisciplinary team; • Offer social support options available to patient and caregiver.

Basic Human Needs (TBHN)	Nursing problem	Basic human needs affected	(ICNP®) Code)	Nursing Diagnoses (ICNP^®)	Nursing care (literature, ICNP^® and experience of specialist nurses)
PSYCHOSPIRITUAL
Religiosity or spirituality	Hope	Religiosity or spirituality	10018614 10009105	Risk of Spiritual Condition, Impaired; Risk of Hopelessness	PRACTICAL CARE • Promote hope through words of comfort; • Promote spiritual support, explaining the importance of spirituality in the illness process, respecting individual beliefs; • Present available social support options; • Support beliefs; • Refer to psychological and/or psychiatric follow-up, if necessary.