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Enquadramento: O percurso realizado e as competências adquiridas neste período de formação são o espelho de um processo que teve como tema central as práticas promotoras do sono do recém-nascido pré-termo (RNPT) em unidades de cuidados intensivos neonatais (UCIN’s) e o desenvolvimento de competências do enfermeiro especialista em enfermagem de saúde infantil e pediátrica (EEESIP). A UCIN combina tecnologia avançada e diferenciada com profissionais de saúde especializados, produzindo um ambiente ruidoso e estimulante. É reconhecido que tanto a manipulação excessiva como a privação do sono no RNPT prejudicam o neurodesenvolvimento. Portanto, torna-se fulcral adotar práticas promotoras do sono do RNPT em UCIN’s. Objetivos: Refletir sobre as experiências e atividades desenvolvidas durante os estágios e o seu contributo para o desenvolvimento de competências do EEESIP; identificar na evidência científica as práticas promotoras do sono no neurodesenvolvimento do RNPT em UCIN´s.
Metodologia: Nos estágios a pesquisa científica e a reflexão crítica sobre as práticas foi a metodologia adotada. Efetuou-se uma revisão integrativa da literatura, adotando como critérios de inclusão: artigos científicos, nos idiomas inglês e português, revistos por peritos, publicados na integra entre 2018 a 2023. A colheita dos dados ocorreu nas bases de dados MEDLINE, CINAHL Complete e RCAAP utilizando os descritores Mesh, agrupados da seguinte forma: sleep AND (promotion or promote or promoting) AND (intensive care units, neonatal or nicu) AND (preterm infants or premature infants or preterm baby or premature baby).
Resultados: Emerge o desenvolvimento de competências especializadas na prestação de cuidados de enfermagem à criança/jovem e família em contexto de cuidados de saúde diferenciados e primários. Como resultados da revisão foram encontrados 23 artigos, contudo, somente 3 artigos preencheram os critérios de inclusão estabelecidos. Verificou-se as seguintes práticas promotoras do sono: gestão do ambiente, concentração de cuidados, respeito pelo sono vigília do RNPT, contenção, sucção não nutritiva, massagem, posicionamento, método canguru e toque humano suave.
Conclusão: Destaca-se a prática baseada na evidência para a melhoria contínua da qualidade dos cuidados de enfermagem. Nos artigos selecionados foram identificadas várias práticas promotoras do sono do RNPT possíveis de executar nas UCIN’s pelos enfermeiros. Deste modo, os estudos incluídos responderam à questão de investigação. Palavras-chave: recém-nascido pré-termo; sono; unidade de cuidados intensivos neonatais; promoção.
Abstract Framework: The path taken and the skills acquired in this training period are the mirror of a process that had as its central theme the practices that promote sleep in preterm newborns (PTNB) in neonatal intensive care units (NICUs) and the development of nurse specialist skills in child and pediatric health nursing (EEESIP). The NICU combines advanced and differentiated technology with specialized healthcare professionals, producing a noisy and stimulating environment. It is recognized that both excessive handling and sleep deprivation in preterm infants harm neurodevelopment. Therefore, it is essential to adopt sleep-promoting practices for PTNBs in NICUs. Objetives: Reflect on the experiences and activities developed during internships and their contribution to the development of EEESIP skills; identify in the scientific evidence sleep-promoting practices in the neurodevelopment of PTNBs in NICUs. Methodology: In the internships, scientific research and critical reflection on practices was the methodology adopted. An integrative review of the literature was carried out, adopting as inclusion criteria: scientific articles, in English and Portuguese, reviewed by experts, published in full between 2018 and 2023. Data collection took place in the MEDLINE, CINAHL Complete and RCAAP using Mesh descriptors, grouped as follows: sleep AND (promotion or promotion or promoting) AND (intensive care units, neonatal or nicu) AND (preterm infants or premature infants or preterm baby or premature baby). Results: The development of specialized skills in the provision of nursing care to children/young people and families in the context of differentiated and primary health care emerges. As results of the review, 23 articles were found, however, only 3 articles met the established inclusion criteria. The following sleep-promoting practices were found: environmental management, concentration of care, respect for the PTNB's sleep and wakefulness, restraint, non-nutritive sucking, massage, positioning, kangaroo method and gentle human touch. Conclusion: Evidence-based practice for continuous improvement in the quality of nursing care stands out. In the selected articles, several sleep-promoting practices for PTNBs that could be carried out by nurses in the NICU were identified. In this way, the included studies answered the research question. Keywords: Premature newborn, sleep, Neonatal Intensive Care Unit; promotion.
Abstract Framework: The path taken and the skills acquired in this training period are the mirror of a process that had as its central theme the practices that promote sleep in preterm newborns (PTNB) in neonatal intensive care units (NICUs) and the development of nurse specialist skills in child and pediatric health nursing (EEESIP). The NICU combines advanced and differentiated technology with specialized healthcare professionals, producing a noisy and stimulating environment. It is recognized that both excessive handling and sleep deprivation in preterm infants harm neurodevelopment. Therefore, it is essential to adopt sleep-promoting practices for PTNBs in NICUs. Objetives: Reflect on the experiences and activities developed during internships and their contribution to the development of EEESIP skills; identify in the scientific evidence sleep-promoting practices in the neurodevelopment of PTNBs in NICUs. Methodology: In the internships, scientific research and critical reflection on practices was the methodology adopted. An integrative review of the literature was carried out, adopting as inclusion criteria: scientific articles, in English and Portuguese, reviewed by experts, published in full between 2018 and 2023. Data collection took place in the MEDLINE, CINAHL Complete and RCAAP using Mesh descriptors, grouped as follows: sleep AND (promotion or promotion or promoting) AND (intensive care units, neonatal or nicu) AND (preterm infants or premature infants or preterm baby or premature baby). Results: The development of specialized skills in the provision of nursing care to children/young people and families in the context of differentiated and primary health care emerges. As results of the review, 23 articles were found, however, only 3 articles met the established inclusion criteria. The following sleep-promoting practices were found: environmental management, concentration of care, respect for the PTNB's sleep and wakefulness, restraint, non-nutritive sucking, massage, positioning, kangaroo method and gentle human touch. Conclusion: Evidence-based practice for continuous improvement in the quality of nursing care stands out. In the selected articles, several sleep-promoting practices for PTNBs that could be carried out by nurses in the NICU were identified. In this way, the included studies answered the research question. Keywords: Premature newborn, sleep, Neonatal Intensive Care Unit; promotion.
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Palavras-chave
Enfermagem pediátrica Recém nascido prematuro Revisão Sono Unidades de cuidados intensivos neonatais Infant premature Neonatal intensive care units Pediatric nursing Review Sleep