Proposta de assistência de enfermagem para pacientes com sepse à luz do referencial teórico de Horta.

Abstract

among the most commonly observed pathologies in the critical care setting, highlights the sepsis. It is known that patients with this pathology and its evolutionary stages - severe sepsis and septic shock - , can present high rate of mortality and several affected human needs, especially those of aspects of psychobiological order. The nurse, for being the member of the multidisciplinary team that stays most of the time providing direct assistance to this patient has great chance to identify early signs of sepsis and provide systematic assistance, based on the method of nursing process through the identification of priority nursing diagnoses that, thereby, can perform efficient interventions before this phenomenon. Objective: drawing a proposal for nursing care, containing diagnostics, results and nursing interventions for patients with sepsis in the light of the theoretical framework of Horta. Methodology: this is a documentary and retrospective study with a quantitative approach. It was used as a source of data collection the medical records of patients admitted to the Adult ICU of two hospitals in the city of Campina Grande-PB. Data were analyzed by means of statistical treatment of the descriptive type and discussed in the light of relevant literature. For the construction of the diagnoses, the classification system was used for the North American Nursing Diagnosis Association International and for the construction of nursing interventions there was used the Nursing Interventions Classification, in addition to the guidelines of the Protocol Surviving Sepsis Campaign. The sample was composed of 28 medical records of patients hospitalized between the months of October to December 2014. The data were collected through structured instrument, built based on Basic Human Needs Theory of Horta, especially the psychobiological needs. It should be emphasized that this research conforms to 466/12 resolution that regulates research involving human subjects and it was held only after approval by the Research Ethics Committee of the Federal University of Campina Grande getting approval through the Protocol n° 899.848. Results: it was found that the sepsis reached 15 (53,6%) men and 13 (46,5%) women, and 13 (46,42%) patients were aged between 61 to 80 years old and 12 (42,9%) were married. The septic shock was the spectrum of severity more incident affecting 13 (46,5%) of individuals and of these, 10 (76,9%) were to death. Pulmonary focus was more incident, occurring in 13 (46,4%) patients. There were identified 27 nursing diagnoses, 476 diagnostic statements with an average of 17 diagnoses per patient. Among the most frequent were 17, which reached frequency greater than or equal to 50% and, of those, eight were often equal to 100%, namely: risk of unstable glycemia, imbalanced nutrition: less than body requirements, impaired urinary elimination, risk of constipation, impaired bed mobility and self-care deficit for bathing/hygiene/food. From these data, results were elaborated and nursing interventions in order to drive the actions of the nurse in a satisfactory manner. Final notes: nursing Diagnostics represent one of the most important sources of specific knowledge of Nursing. When linked to interventions leads the actions of the nurse in a satisfactory and precise manner. Being a pathology of sepsis rapidly advancing, it becomes necessary that the strategies for their control are prepared in advance, thus promoting the improvement of the quality of care provided to the septic patient.