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Utilização inadequada do serviço de urgência por crianças com idade inferior a dois anos
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Introdução: O uso inadequado do Serviço de Urgência Pediátrica, sobretudo em crianças com menos de dois anos, constitui uma problemática relevante para a prática dos enfermeiros, com impacto na organização, na qualidade e na eficiência dos cuidados, bem como na gestão dos recursos de saúde. Entre os fatores associados, destacam-se a menor confiança dos pais/cuidadores nos Cuidados de Saúde Primários, as barreiras ao acesso a estes serviços e a ansiedade parental.
Objetivo: Descrever criticamente o percurso formativo desenvolvido em diferentes contextos de ensino clínico, visando a aquisição de competências comuns e específicas do Enfermeiro Especialista em Enfermagem de Saúde Infantil e Pediátrica, e analisar a evidência científica sobre a utilização inadequada do Serviço de Urgência Pediátrica em crianças com menos de dois anos.
Metodologia: Relatório de análise reflexiva das competências adquiridas nos estágios de urgência pediátrica, de neonatologia e de internamento de pediatria. Realização de uma revisão integrativa segundo as orientações PRISMA e JBI, com pesquisa nas bases de dados MEDLINE, CINAHL, PubMed e b-On, incluindo estudos publicados entre 1 de janeiro de 2016 e a data da pesquisa.
Resultados: Foram incluídos 14 dos 381 estudos identificados. A utilização não urgente do Serviço de Urgência Pediátrica varia conforme o contexto, a população e os critérios adotados, sendo mais frequente em recém-nascidos, lactentes e crianças mais novas. Os principais fatores associados incluem ansiedade parental, perceção subjetiva de gravidade, baixa literacia em saúde, dificuldades no acesso aos Cuidados de Saúde Primários e autorreferenciação.
Conclusão: Trata-se de um fenómeno multifatorial, influenciado por fatores parentais, organizacionais e sociais. A capacitação dos pais/cuidadores, o reforço da literacia em saúde e a melhoria do acesso aos Cuidados de Saúde Primários são estratégias centrais para promover uma utilização mais adequada, segura e eficiente do Serviço de Urgência Pediátrica, destacando-se, ainda, a importância da intervenção precoce do Enfermeiro Especialista.
Palavras-chave: Lactente; Criança; Serviço Hospitalar de Emergência; Uso Indevido de Serviços de Saúde
Abstract Introduction: Inappropriate use of the Pediatric Emergency Department, particularly among children under two years of age, is a relevant issue for nursing practice, with an impact on the organization, quality, and efficiency of care, as well as on the management of healthcare resources. Among the associated factors are parents’/caregivers’ lower confidence in Primary Health Care, barriers to accessing these services, and parental anxiety. Objective: To critically describe the training pathway developed in different clinical teaching settings, aimed at acquiring the common and specific competencies of the Nurse Specialist in Child and Pediatric Health Nursing, and to analyze the scientific evidence on the inappropriate use of the Pediatric Emergency Department in children under two years of age. Methodology: Reflective analysis report on the competencies acquired during clinical placements in pediatric emergency care, neonatology, and pediatric inpatient care. An integrative review was conducted according to PRISMA and JBI guidelines, with searches conducted in MEDLINE, CINAHL, PubMed, and b-On databases, including studies published between January 1, 2016, and the search date. Results: Fourteen of the 381 identified studies were included. Non-urgent use of the Pediatric Emergency Department varies by context, population, and adopted criteria, and is more frequent among newborns, infants, and younger children. The main associated factors include parental anxiety, subjective perception of severity, low health literacy, difficulties in accessing Primary Health Care, and self-referral. Conclusion: This is a multifactorial phenomenon influenced by parental, organizational, and social factors. Empowering parents/caregivers, strengthening health literacy, and improving access to Primary Health Care are central strategies to promote a more appropriate, safe, and efficient use of the Pediatric Emergency Department, while also highlighting the importance of early intervention by the Nurse Specialist. Keywords: Infant; Child; Emergency Service, Hospital; Misuse of Health Services.
Abstract Introduction: Inappropriate use of the Pediatric Emergency Department, particularly among children under two years of age, is a relevant issue for nursing practice, with an impact on the organization, quality, and efficiency of care, as well as on the management of healthcare resources. Among the associated factors are parents’/caregivers’ lower confidence in Primary Health Care, barriers to accessing these services, and parental anxiety. Objective: To critically describe the training pathway developed in different clinical teaching settings, aimed at acquiring the common and specific competencies of the Nurse Specialist in Child and Pediatric Health Nursing, and to analyze the scientific evidence on the inappropriate use of the Pediatric Emergency Department in children under two years of age. Methodology: Reflective analysis report on the competencies acquired during clinical placements in pediatric emergency care, neonatology, and pediatric inpatient care. An integrative review was conducted according to PRISMA and JBI guidelines, with searches conducted in MEDLINE, CINAHL, PubMed, and b-On databases, including studies published between January 1, 2016, and the search date. Results: Fourteen of the 381 identified studies were included. Non-urgent use of the Pediatric Emergency Department varies by context, population, and adopted criteria, and is more frequent among newborns, infants, and younger children. The main associated factors include parental anxiety, subjective perception of severity, low health literacy, difficulties in accessing Primary Health Care, and self-referral. Conclusion: This is a multifactorial phenomenon influenced by parental, organizational, and social factors. Empowering parents/caregivers, strengthening health literacy, and improving access to Primary Health Care are central strategies to promote a more appropriate, safe, and efficient use of the Pediatric Emergency Department, while also highlighting the importance of early intervention by the Nurse Specialist. Keywords: Infant; Child; Emergency Service, Hospital; Misuse of Health Services.
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Palavras-chave
Lactente Mau uso dos serviços de saúde Pais Recém nascido Revisão integrativa Serviço de urgência hospitalar Emergency service hospital Health services misuse Infant Infant newborn Integrative review Parents