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KNOWLEDGE AND DIFFICULTIES OF NURSES IN MECHANICAL VENTILATION IN A TRAUMA UNIT IN A TERTIARY CENTER IN PERNAMBUCO

Meline Rossetto Kron-Rodrigues, Hítalo Cavalcanti Vasconcelos, Noélle De Oliveira Freitas, Alfredo Almeida Pina-Oliveira

Abstract: Objective: To analyze the knowledge and difficulties in the assistance provided by trauma emergency nurses to patients on mechanical ventilation (MV) in a tertiary hospital located in RecifePE. Method: This is a cross-sectional study with a complementary quantitative and qualitative approach that was conducted in the Trauma Emergency Unit of the Hospital da Restauração, RecifePE. Data were collected in June 2021 using a questionnaire that assessed 4 domains of mechanical ventilation knowledge, these being: initial setting of the invasive ventilator and conventional ventilatory modes, monitoring the patient on ventilatory support, nursing care in patients on invasive ventilatory support, and sedation and analgesia during mechanical ventilation. The difficulties were measured by means of open questions at the end of the questionnaire. Inclusion criteria were: being a nurse assistant in the Trauma Emergency Department. Nurses working in administrative positions, on vacation or on leave during the data collection period were excluded. The research was approved by the Research Ethics Committee through opinion #4.704.572 and all participants previously signed the Informed Consent Form (TCLE). Results: Thirty nurses were analyzed, 80% were women, 43.5% were married and 67% were between 31 and 42 years old. As for the time of training in higher education, 40% revealed having up to 10 years of graduation, without other graduation in 87% of respondents and reported not having a technical course in nursing in 83%. Nursing care to patients on invasive ventilatory support, especially with regard to handling, as well as cleaning and conservation of equipment was deficient among the interviewees. Sedation and analgesia during mechanical ventilation were deficient when the use of neuromuscular blockade for deep sedation and adequate monitoring of the level of consciousness were mentioned. Among the difficulties when assisting the patient under mechanical ventilation, one can include the correct management of the ventilator, as well as the adjustment of its parameters adequate for each patient, ventilator assembly, interpreting the parameters, as well as the existence of high demand, lack of material to maintainadequate sedation of the patient, and prevention of ventilator-related accidents. As a facility, care actions such as assisting the intubation procedure, decubitus monitoring, sedation installation, basic parameters maintenance and endotracheal suctioning were mentioned. Conclusions: The authors suggest that continued education and specific training actions should be implemented to improve the assistance of nurses who assist MV patients in emergency units.
Keywords: difficulties in the assistance / patient under mechanical ventilation / nurses / nurse assistant / invasive ventilatory / Nursing care

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