CLINICAL CHARACTERIZATION AND CROSS-MAPPING OF THE NURSING INTERVENTIONS FOR HYPOTHERMIA IN THE INTRAOPERATIVE PERIOD

Almeida, Talita Evelyn Freire Araujo; Alves, Élen de Lima; Araújo, Ana Paula Albano; Lordelo, Daniela de Souza; Silva, Flávia Janólio Costacurta Pinto da; Andrade, Joseilze Santos de

doi:10.1590/1980-265X-TCE-2020-0463

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Original Article • Texto contexto - enferm. 30 • 2021 • https://doi.org/10.1590/1980-265X-TCE-2020-0463 copy

CLINICAL CHARACTERIZATION AND CROSS-MAPPING OF THE NURSING INTERVENTIONS FOR HYPOTHERMIA IN THE INTRAOPERATIVE PERIOD

CARACTERIZACIÓN CLÍNICA Y MAPEO CRUZADO DE LAS INTERVENCIONES DE ENFERMERÍA PARA HIPOTERMIA EN EL PERÍODO INTRAOPERATÓRIO

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objectives:

to map the Nursing prescriptions for patients with diagnoses related to hypothermia in the intraoperative period with the activities proposed by the Nursing Interventions Classification, and to characterize the sample based on the risk factors for the development of this discomfort.

Method:

a descriptive, documentary and retrospective study, with a quantitative approach that followed three stages: cataloging of the interventions, documentary analysis, and cross-mapping. The following variables were analyzed: patient's age and gender; surgery duration; minimum, mean and maximum temperatures, and variation of the surgery room and patient temperatures; and whether or not the type of surgery involved opening a body cavity, in a sample of 138 medical charts evaluated from August to September 2019 by using a checklist composed of identification data and diagnosis components from the NANDA-International diagnoses: risk of perioperative hypothermia and hypothermia. Absolute and percentage frequency analyses, mean, standard deviation, and the R software were employed.

Results:

419 activities incorporated in 12 interventions were verified that were related to hypothermia in the corresponding taxonomy; as well as 13 Nursing care measures prescribed and five interventions mapped. The variables which reached significance were surgery duration and cavity opening.

Conclusion:

by means of cross-mapping, it can be asserted that the care measures prescribed are based on the standardized language, thus contributing to unification of the Nursing practice.

DESCRIPTORS:
Standardized Nursing terminology. Hypothermia. Intraoperative period. Perioperative Nursing. Nursing records; Nursing care

Variable	d.f.^*	Deviance	p
Risk of perioperative hypothermia
Age	121	0.10	0.74	n.s. ^†
Gender	120	0.18	0.66	n.s.
Age:gender	119	1.53	0.21	n.s.
Surgery duration	120	5.09	0.02	^* ^‡
OR minimum temperature	121	0.005	0.98	n.s.
OR mean temperature	121	0.17	0.67	n.s.
OR maximum temperature	121	0.18	0.66	n.s.
Cavity opening	120	6.18	0.01	^*
Hypothermia diagnosis
Age	121	0.12	0.72	n.s.
Gender	120	0.19	0.65	n.s.
Age:gender	119	0.97	0.32	n.s.
Surgery duration	120	6.12	0.01	^*
OR minimum temperature	121	0.12	0.72	n.s.
OR mean temperature	121	0009	0.95	n.s.
OR maximum temperature	121	0.02	0.87	n.s.
Cavity opening	120	7.37	0.001	^*

Nursing prescriptions	ʃ ^* (%)	Monthly mean	SD(±)
Monitor vital signs	90 (22.5)	15.0	3.3
Control OR temperature	88 (22.0)	14.7	2.8
Cover the patient	47 (11.7)	7.8	1.1
Install the thermal blanket	108 (27.0)	18.0	1.5
Minimize patient's exposure	30 (7.5)	5.0	3.2
Infuse heated solutions	17 (4.2)	2.8	0.9
Promote extra warming measures	5 (1.2)	0.8	0.4
Assess peripheral perfusion	4 (1.0)	0.7	0.7
Monitor skin color, temperature, and moisture	4 (1.0)	0.7	0.5
Monitor oximetry	4 (1.0)	0.7	0.7
Monitor signs of hypothermia	3 (0.7)	0.5	0.6

Variable	d.f.^*	Deviance	p
Number of interventions
Age	121	0.05	0.98	n.s. ^†
Gender	120	0.12	0.72	n.s.
Age:gender	119	1.31	0.57	n.s.
Risk of perioperative hypothermia	121	1.65	0.20	n.s.
Hypothermia diagnosis	121	2.22	0.13	n.s.
Surgery duration	120	1.29	0.25	n.s.
Cavity opening	120	6.18	0.01	^* ^‡

Interventions	Activities	Prescriptions
Temperature Regulation: Perioperative	Install and regulate the active heating device	Install the thermal blanket
	Adjust room temperature to minimize risk of hypothermia	Control room temperature
	Minimize patient's exposure during surgical preparation and procedure	Minimize patient's exposure
	Provide hot or cold irrigating solutions	Infuse heated venous solutions
Temperature Regulation	Use a heating mattress, warm blankets, and a warm environment to increase body temperature	Promote extra warming measures
Hypothermia Treatment	Remove cold and wet clothes from the patient	Replace wet clothes for dry ones
	Apply active external reheating	Cover the patient
	Identify medical, environmental and other factors that might favor hypothermia	Control air drafts in the operating room
Hemodynamic Regulation	Monitor peripheral pulses, capillary refill, and limbs' temperature and colors	Assess peripheral perfusion
Vital Signs Monitoring	Monitor and report signs and symptoms of hypothermia and hyperthermia	Monitor signs of hypothermia
	Monitor skin color and temperature	Monitor skin color, temperature, and moisture
	Monitor pulse oximetry	Monitor oximetry
	Monitor blood pressure, pulse, temperature and respiratory status, as appropriate	Monitor vital signs

Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem Campus Universitário Trindade, 88040-970 Florianópolis - Santa Catarina - Brasil, Tel.: (55 48) 3721-4915 / (55 48) 3721-9043 - Florianópolis - SC - Brazil
E-mail: textoecontexto@contato.ufsc.br

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[1] CORRESPONDING AUTHOR
Talita Evelyn Freire Araujo Almeida talita.freire18@gmail.com