90 - Nursing Care for Patients at Risk for Perioperative Positioning Injury
Clinica Issue: Introduction: Studies on surgical positioning indicate that this is an essential care for perioperative nurses, and interventions for risk prevention should be guided by an organized and systematic process. In this context, the nurse's assessment guided by the stages of the Nursing Process (PE) stands out favoring the dynamics of perioperative work. Perioperative nurses usually establish the nursing diagnosis Risk for perioperative positioning injury (RLPP) of the NANDA International (NANDA-I) taxonomy for patients. However, there is little evidence in the literature about which nursing care is implemented in perioperative clinical practice for patients with this diagnosis.
Objective: To analyze the nursing care prescribed by nurses for patients diagnosis with RLPP.
Method: This study is part of a larger cohort study conducted in the operating suite of a university hospital in Southern Brazil. The sample included adult patients who underwent elective surgical procedures requiring anesthesia. Sociodemographic data, clinical data, perioperative data were collected and the Risk Assessment Scale for the Development of Injuries Due to Surgical Positioning (ELPO) was applied. The prescribed nursing care was collected from the nursing prescriptions available in the electronic medical record. For this diagnosis, 14 nursing care are registered in the computerized system of the institution under study, which is based on the use of NANDA-I and Nursing Intervention Classification taxonomies. Data analysis was performed using descriptive statistics using SPPS version 18.0. The project was approved by the Research Ethics Committee of the institution under number 14075.
Results: The patients were predominantly male, mean age 54 (± 15) years. The mean ELPO score was 20 (± 3) points. The predominant surgical positioning was supine for 21 (42%) patients and lateral for 15 (30%). Among the care most evident in nursing prescriptions were Minimizing injuries during patient transfer from operating table to stretcher to 47 (94%) patients, Monitoring position of equipment accessories in 47 (94%) patients, Reporting change in color and temperature extremities for 46 (92%) patients and Monitor sources of pressure and skin friction in 46 (92%) patients.
Conclusion: The nursing care prescribed for patients diagnosis with RLPP reflects the level of complexity of care in surgical positioning, especially with preventive interventions. The use of PE associated with taxonomies favors the record of care implemented in the operating room, highlighting the quality and safety of patient care.