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      Aspiração endotraqueal: estudo em pacientes de uma unidade de urgência e terapia intensiva de um hospital da regiao metropolitana de Natal - RN Translated title: Aspiración de las vias aéreas superiores: análisis em enfermos de una unidad de urgencia y terapia intensiva de un hospital en la región metropolitana de Natal - RN Translated title: Intratracheal suction: study in patients of an emergency and intensive care unit in a hospital of the metropolitan region of Natal City - RN

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          Abstract

          A aspiração endotraqueal é um recurso mecânico simples e importante na rotina hospitalar. É amplamente utilizado em pacientes em Unidade de Terapia Intensiva (UTI), sob ventilação mecânica ou não. Objetivamos nesse estudo caracterizar os profissionais que realizam o procedimento de aspiração das vias aéreas superiores e identificar como está sendo realizado esse procedimento. A pesquisa é do tipo exploratório descritivo com dados prospectivos e abordagem quantitativa, realizada nas Unidades de Urgência e UTI de um Hospital da grande Natal-RN. A população constou de 14 enfermeiros, 22 técnicos de enfermagem, 14 auxiliares de enfermagem, 03 médicos e 07 fisioterapeutas. Empregou-se na coleta dos dados a técnica de observação estruturada. O instrumento constou de um protocolo de aspiração baseado nas diretrizes da Agência Nacional de Vigilância Sanitária, Ministério da Saúde e o do Guidelines for Prevention of Nosocomial Pneumonia do Centro de Controle de Doenças (CDC, 1997). Constatamos que as diretrizes norteadoras deste procedimento não eram levadas em consideração em quase todos os passos deste cuidado. O que mais chamou a atenção foi a falta da lavagem das mãos antes (92,81%) e após (50,29%) este cuidado. A pouca participação do enfermeiro, (3,59%) nesta atividade também é considerado um ponto de extrema relevância por se tratar de unidade de cuidados de alta complexidade. Os dados apontam a necessidade de intensificar as atividades educativas que promovam a mudança de comportamento destes profissionais, melhorando assim a qualidade da assistência e a prevenção de infecções nosocomiais.

          Translated abstract

          La aspiración endotraqueal es un recurso mecánico muy sencillo e importante en la rutina hospitalar. Es utilizado con mucha frecuencia en enfermos ingresados en unidad de terapia intensiva (UTI), bajo ventilación mecánica o no. Objetivamos en ese trabajo caracterizar los profesionales que realizan el procedimiento de aspiración de las vías aéreas superiores e identificar de que modo está siendo realizado ese procedimiento. La pesquisa es del tipo exploratorio descriptivo con datos prospectivos y abordaje cuantitativo, realizada en las unidades de urgencia y UTI de un hospital alrededor de Natal. La población era formada por 14 enfermeros, 22 técnicos de enfermería, 14 auxiliares de enfermería, 03 médicos y 07 fisioterapeutas. Se ha empleado en la colecta e datos, la técnica de observación estructurada. El instrumento consistía de un protocolo de aspiración basado en las directrices de la agencia nacional de vigilancia sanitaria, Ministerio de la Salud y del Guidelines for Prevention of Nosocomial Pneumonia del Centro de Control de Enfermedades (CDC, 1997). Hemos constatado que las directrices orientadoras de ese procedimiento no eran llevadas en cuenta en casi todos los pasos lo que más llamó la atención ha sido la falta de limpieza de las manos antes (92,81%) y después (50,29%). La participación muy pequeña de los enfermeros (3,59%) en esta actividad también es considerada un asunto de extrema importancia por tratarse de unidad de cuidados de alta complicación. Los datos apuntan hacia la necesidad de intensificar las actividades educativas que promuevan la mudanza de comportamiento de eses profesionales mejorando de esa manera la calidad de la asistencia y la prevención de infecciones nosocomiales.

          Translated abstract

          Intratracheal suction is a simple and important mechanical procedure on hospital routine. It’s largely used on patients in Intensive Care Units (ICU), under mechanical ventilation or not. This study seeks to characterize the professionals that perform the procedure of upper air tracts aspiration and identify how this procedure is being performed. The research is of the descriptive exploratory type with prospective data and quantitative approach, performed on the Emergency Room and ICU of a hospital in the greater Natal-RN. The population is comprised of 14 nurses, 22 nursing technicians, 14 nursing auxiliaries, 03 physicians and 07 physiotherapists. The structure observation technique was employed in the data collection. The instrument was comprised of a suction protocol based on the directives of the Agência Nacional de Vigilância Sanitária, Ministério da Saúde, and of the Guidelines for Prevention of Nosocomial Pneumonia of the Center for Disease Control (CDC, 1997). We’ve discovered that the guidelines for this procedure were not taken into consideration in almost every step of this care. The most outstanding discovery was the absence of hand washing before (92,81%) and after (50,29%) this care. The small participation of the nurse (3,59%) on this activity is also considered a point of extreme relevance, since it’s a unit for care of extreme complexity. The data indicate the need to intensify the educating activities that promote a change of behavior on these professionals, thus improving the quality of assistance and prevention of nosocomial infections.

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          Most cited references 28

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          Fisioterapia Respiratória Básica

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            Manual de condutas. Exposição ocupacional a material biológico: hepatite e HIV

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              A multisite survey of suctioning techniques and airway management practices.

              Ventilator-associated pneumonia, common in critically ill patients, is associated with microaspiration of oropharyngeal secretions and may be related to suctioning and airway management practices. To describe institutional policies and procedures related to closed-system suctioning and airway management of intubated patients, and to compare practices of registered nurses and respiratory therapists. A descriptive, comparative, multisite study of facilities that use closed-system suctioning devices on most intubated adults was conducted. Nurses and respiratory therapists who worked at the sites completed surveys related to their practices. A total of 1665 nurses and respiratory therapists at 27 sites throughout the United States responded. The typical respondent had at least 6 years' experience with patients receiving mechanical ventilation (61%) and a baccalaureate degree or higher (54%). Most sites had policies for management of endotracheal tube cuffs (93%), hyperoxygenation (89%) and use of gloves (70%) with closed-system suctioning, and instillation of isotonic sodium chloride solution for thick secretions (74%). Only 48% of policies addressed oral care and 37% addressed oral suctioning. Nurses did more oral suctioning and oral care than respiratory therapists did, and respiratory therapists instilled sodium chloride solution more and rinsed the suctioning device more often than nurses did. Policies vary widely and do not always reflect current research. Consistent performance of practices such as wearing gloves for airway management and maintaining endotracheal cuff pressures must be evaluated. Collaborative, research-based policies and procedures must be developed and implemented to ensure best practices for intubated patients.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                ree
                Revista Eletrônica de Enfermagem
                Rev. Eletr. Enf.
                Universidade Federal de Goiás
                1518-1944
                April 2006
                : 8
                : 1
                : 63-69
                Affiliations
                [1 ] Universidade Federal do Rio Grande do Norte (UFRN) Brasil
                [2 ] Universidade Federal do Rio Grande do Norte (UFRN) Brasil
                [3 ] Universidade Federal do Rio Grande do Norte (UFRN) Brasil
                Article
                S1518-19442006000100009

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.

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