Covid-19 beyond the disease: effects of the pandemic on the neonatal intensive care in the light of Nightingale’s environmental theory

Machado, Iara Caroline Silva; Rocha, Amanda Chaves; Amaral, Alda Silva Nery; Lima, Raquel Cristina Gomes; Santos, Juliana Oliveira; Manfroi, Edi Cristina; Medeiros, Danielle Souto de

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Original articles • Saude soc. 31 (1) • 2022 • https://doi.org/10.1590/S0104-12902022201010 copy

Covid-19 beyond the disease: effects of the pandemic on the neonatal intensive care in the light of Nightingale’s environmental theory

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The strict safety measures adopted in hospital environments due to the pandemic have also been extended to Neonatal Intensive Care Units (NICU). By means of a systematic observation and based on Nightingale’s Environmental Theory, this article sought to unveil the organizational and structural changes in the NICU of a public hospital in the countryside of Bahia. Results indicate an interconnection between physical, psychological, and social environments, which were committed to the communication and relationship between family, newborn, and team, thus presenting a sensitive bias of the restrictive consequences of covid-19. These findings highlight the paradox between ensuring security and preventing informational and bond-facilitator practices that involve the aforementioned triad. From this context emerge new communication strategies leading professionals to reinvent themselves, and to dare in communication by remote resources not used before, emphasizing the use of digital technologies.

Keywords:
Neonatal Intensive Care Unit; Relatives; Communication; Health Technologies

PHYSICAL ENVIRONMENT	PSYCHOLOGICAL ENVIRONMENT	SOCIAL ENVIRONMENT
Is there a change in the Physical Environment?	Is there a change in the Psychological Environment?	Is there a change in the Social Environment?
( ) Yes ( ) No	( ) Yes ( ) No	( ) Yes ( ) No
Please specify:	Please specify:	Please specify:

PHYSICAL ENVIRONMENT	PSYCHOLOGICAL ENVIRONMENT	SOCIAL ENVIRONMENT
•Environment that intensified sanitization of surfaces in general;	•Environment that required constant use of PPE;	•Site that restricted NICU stay to 1 h/day;
•Site that required increased use of PPE;	•Environment that increased biosecurity control at the parents’ entrance;	•Environment that restricted access by the extended family;
•Environment that began to have access restricted to parents;	•Environment that was affected by temporary staff reduction;	•Environment that experienced less dedication to demands for interaction;
•An environment that temporarily reduced the number of beds;	•Site that possibly caused an work overload.*	•Environment that reinvented itself in forms of communicating with family members.
•Environment that adapted space for milking breast milk to create a bed for respiratory isolation.

Faculdade de Saúde Pública, Universidade de São Paulo. Associação Paulista de Saúde Pública. Av. dr. Arnaldo, 715, Prédio da Biblioteca, 2º andar sala 2, 01246-904 São Paulo - SP - Brasil, Tel./Fax: +55 11 3061-7880 - São Paulo - SP - Brazil
E-mail: saudesoc@usp.br

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[1] Correspondence Iara Caroline Silva Machado Universidade Federal da Bahia. Campus Anísio Teixeira. Rua Hormindo Barros, 58, Quadra 17, Lote 58, Bairro Candeias. Vitória da Conquista, BA, Brazil. CEP: 45.029-094.