Avaliação e controle da dor pelo enfermeiro em unidades de terapia intensiva: revisão integrativa.

Abstract

The Intensive Care Unit (ICU), consists of a specialized place for the care of critically ill patients. In these circumstances, patients, often, undergo invasive procedures that trigger or can intensify the pain. It is important to emphasize that the phenomenon of pain, it is a bit worrying problem, in the view of some health professionals, including nurses, however, it is known that controlling not the painful condition can cause several repercussions for the patient, including, respiratory, hemodynamic, metabolic and increased length of hospital stay changes. Objective: To conduct a survey on the assessment and pain management by nurses in ICU. Methodology: This is an integrative review of the literature, realized in January 2015, in the databases Medical Literature analysis and Retrieval System Online (MEDLINE); Literature Latin American and Caribbean Health Sciences (LILACS) and electronic library Scientific Electronic Library Online (SciELO). Was used as the search strategy: "Pain AND intensive care units AND Nursing". As inclusion standards, the publications were delimited between 2009-2014, which were fully available and in the idioms portuguese, english and spanish. The sample consisted of 13 articles. Results: there was a bigger number of surveys, between the years 2011 and 2013, which represented three (23,1%) and six (46,2%) articles, respectively. Concerning the country of origin, six (46,2%) studies were from the United States of America (USA); six (46,2%) from Brazil and one (7,7%) from Iran. As instruments for specific evaluation of pain in critically ill patients, were utilized Behavioral Pain Scale- BPS (behavioral pain scale) and the Critical-Care Pain Observation Tool (CPOT). Were identified, two protocols for pain control, which aim in common, decreased sedation, so that slowly the patients are disconnected from the ventilator, and so the days of hospitalization have decreased. Conclusion: It can be seen that most studies report that nurses knowledge about the identification, evaluation and pain control is insufficient. Some studies show that the nursing professionals, recognize the importance of pain measurement and registration thereof with the fifth vital sign, however, do not assess and record their occurrence in clinical practice. The use of scales and clinical protocols for pain control and sedation in critically ill patients constitute essential elements for the improvement of nursing care quality and to promote shorter mechanical ventilation and hospitalization. Based on this evidence, pointing to the need of more research and studies about this theme. Thus, it is expected that this research will contribute to the improvement of knowledge about the assessment and management of pain by nurses in ICU.