Unidades de cuidados intensivos neonatales

  • 文章类型: Journal Article
    背景:以家庭为中心的发展护理(FCDC)是新生儿监护病房(NICU)的一种护理理念,基于感官刺激的控制,适当的位置和新生儿和家庭参与的护理。护理人员是这种护理的主要提供者。控制COVID-19的卫生措施,如使用口罩,阳性病例的隔离和容量限制,以FCDC的实施为条件。
    目的:了解新生儿重症监护病房(NICU)护理人员的经验对FCDC实施的意义,根据为遏制COVID-19而采取的卫生措施。
    方法:从招募NICU护士的描述性现象学范式进行了一项定性研究。定性数据收集是通过不限成员名额和半结构化访谈进行的。通过对线人护士的叙述和话语进行初步的叙述分析和主题分析,分别对这些进行了分析。
    结果:进行了3次开放式访谈和7次半结构化访谈,其中出现了三个主要主题:1)FCDC的变化源于为遏制COVID-19而实施的卫生限制;2)大流行背景下人际关系的变化,3)向常态过渡。
    结论:NICU的护士认为,由于COVID-19的遏制,FCDC的实施发生了变化,改变了与NB父母的关系,加速他们作为看护者的训练,并涉及视频通话等新措施的实施。
    BACKGROUND: Family centered developmental care (FCDC) are a philosophy of care in the neonatal care units (NICU), based on the control of sensory stimulation the adequate position and of newborn and the family involvement of cares. Nursing staff are the main providers of this care. Sanitary measure to control of the COVID-19, such as the use of masks, isolation of positive cases and capacity limit, conditioned the implementation of FCDC.
    OBJECTIVE: To understand the meaning of the experience of the nursing staff of a neonatal intensive care unit (NICU) on the implementation of the FCDC, under the sanitary measures imposed for the containment of COVID-19.
    METHODS: A qualitative study was conducted from the descriptive phenomenological paradigm in which NICU nurses were recruited. The qualitative data collection was carried out through open-ended and semi-structured interviews. These were analyzed respectively through a preliminary narrative analysis and a thematic analysis of the informant nurses\' narratives and discourses.
    RESULTS: Three open-ended and 7 semi-structured interviews were conducted from which three main topics emerged: 1) changes in the FCDC derived from the sanitary restrictions implemented for the containment of COVID-19; 2) changes in interpersonal relationships in the context of a pandemic, and 3) transition to normality.
    CONCLUSIONS: The nurses of NICU perceived changes in the implementation of the FCDC due to the containment of COVID-19, that modified the relationship with the parents of NB, accelerating their training as caregivers, and involved the implementation of new measures such as video calls.
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  • 文章类型: Journal Article
    疼痛识别和管理仍然是新生儿重症监护病房卫生专业人员的挑战。许多患者经常遭受反复的痛苦经历,并表现出短期和长期后果。早产儿是一个脆弱的高危人群。尽管有国际建议,在许多新生儿重症监护病房中,疼痛评估和管理仍然不佳.由于没有通用协议,不同新生儿重症监护病房的疼痛方法和治疗指南存在显著差异.本文的目的是回顾和评估疼痛在发展初期的一般原则,通过使用标准化量表来识别它。它还包括药物和非药物措施相结合的预防和管理,以及通过优化新生儿重症监护病房的疼痛和压力控制,建立有助于缓解日常临床实践中疼痛的建议。
    Pain recognition and management continues to be a challenge for health professionals in Neonatal Intensive Care Units. Many of the patients are routinely exposed to repeated painful experiences with demonstrated short- and long-term consequences. Preterm babies are a vulnerable high-risk population. Despite international recommendations, pain remains poorly assessed and managed in many Neonatal Intensive Care Units. Due to there being no general protocol, there is significant variability as regards the guidelines for the approach and treatment of pain between the different Neonatal Intensive Care Units. The objective of this article is to review and assess the general principles of pain in the initial stages of development, its recognition through the use of standardised scales. It also includes its prevention and management with the combination of pharmacological and non-pharmacological measures, as well as to establish recommendations that help alleviate pain in daily clinical practice by optimising pain and stress control in the Neonatal Intensive Care Units.
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