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Advisor(s)
Abstract(s)
Enquadramento: Os cuidados ao cordão umbilical foram ao longo dos anos considerados
fulcrais e foram sofrendo mudanças consideráveis, muito ao sabor dos tempos ou experiência
do prestador de cuidados.
Objetivo: Identificar recomendações baseadas na evidência científica, de boas práticas nos
cuidados de promoção da queda e prevenção da infecção do coto umbilical do RN.
Métodos: Realizou-se uma revisão sistemática da literatura de estudos realizados nos idiomas
português, espanhol e inglês, publicados posteriormente ao ano 2000, em bases de dados
internacionais como a Medline, Cochrane, Scielo, B-on, Lilacs, Uptodate, American
Academy of Pediatrics, Proquest, World Health Organization, com recurso a diversos
descritores e operadores booleanos e recorrendo a dois revisores que avaliaram a qualidade
dos estudos metodológicos.
Resultados: Após avaliação crítica, foram excluídos 32 artigos e 14 incluídos, dos quais 11
de evidência A, 1 evidência B e 2 evidência D. Os outcomes mostraram a técnica dry care
como a mais adequada nos cuidados ao coto umbilical, nomeadamente em países
desenvolvidos onde a vigilância e os cuidados de saúde estão ao acesso de todos os indivíduos
(Grau de Evidencia A). Esta técnica reduz ainda o tempo de queda do coto umbilical, quando
comparada com a aplicação de solutos. Contudo, em regiões onde a taxa de infecção e
mortalidade neonatal são elevadas, a aplicação de solutos, como a clorohexidina, é
considerado o mais adequado, ainda que estes atrasem o tempo de queda do coto umbilical
(Grau de Evidência A).
Conclusões: Os enfermeiros devem procurar orientar a sua prática com base nas evidências
científicas e tendo como suporte o estudo efectuado, recomenda-se o método dry care nos
cuidados ao coto umbilical, ainda que este não seja o método tradicionalmente definido em
todas as instituições.
Palavras - Chave: cuidados ao coto umbilical, práticas de enfermagem, aplicação de solutos,
dry care.
ABSTRACT Background: The Care of the umbilical cord have been considered over the years and considerable changes key, much to the flavor of the times or experience of the caregiver were suffering. Objective: To identify recommendations based on scientific evidence, good practice in the care of promoting fall and preventing infection of the umbilical stump of newborns. Methods: We conducted a systematic literature review of studies conducted in Portuguese, Spanish and English, published after the year 2000 in international databases such as Medline, Cochrane, SciELO, B-on, Lilacs, Uptodate, American Academy of Pediatrics, Proquest, World Health Organization, using various descriptors and Boolean operators and using two reviewers who assessed the methodological quality of studies. Results: A critical review, 32 articles were excluded and 14 included, of which 11 of evidence A, 1 evidence B and 2 evidence D. The outcomes showed the technique dry care as the most appropriate care in the care of the umbilical stump, particularly in developed countries where surveillance and health care access are all individuals (Level of evidence a). This technique also reduces the fall time of the umbilical stump, compared with the use of solutes. However, in regions where the rate of infection and neonatal mortality are high, the application of solutes, such as chlorhexidine, is considered the most suitable, even if they delay the time of umbilical cord stump (Level of Evidence A). Conclusions: Nurses should seek to guide their practice based on scientific evidence and having as support the study performed, it is recommended to dry care in care of the umbilical stump method, although this is not the method traditionally defined in all institutions. Key - Words: Care of the umbilical stump, nursing practices, application of solutes, dry care.
ABSTRACT Background: The Care of the umbilical cord have been considered over the years and considerable changes key, much to the flavor of the times or experience of the caregiver were suffering. Objective: To identify recommendations based on scientific evidence, good practice in the care of promoting fall and preventing infection of the umbilical stump of newborns. Methods: We conducted a systematic literature review of studies conducted in Portuguese, Spanish and English, published after the year 2000 in international databases such as Medline, Cochrane, SciELO, B-on, Lilacs, Uptodate, American Academy of Pediatrics, Proquest, World Health Organization, using various descriptors and Boolean operators and using two reviewers who assessed the methodological quality of studies. Results: A critical review, 32 articles were excluded and 14 included, of which 11 of evidence A, 1 evidence B and 2 evidence D. The outcomes showed the technique dry care as the most appropriate care in the care of the umbilical stump, particularly in developed countries where surveillance and health care access are all individuals (Level of evidence a). This technique also reduces the fall time of the umbilical stump, compared with the use of solutes. However, in regions where the rate of infection and neonatal mortality are high, the application of solutes, such as chlorhexidine, is considered the most suitable, even if they delay the time of umbilical cord stump (Level of Evidence A). Conclusions: Nurses should seek to guide their practice based on scientific evidence and having as support the study performed, it is recommended to dry care in care of the umbilical stump method, although this is not the method traditionally defined in all institutions. Key - Words: Care of the umbilical stump, nursing practices, application of solutes, dry care.
Description
Keywords
Cordão umbilical Cuidado pós-natal Cuidados de enfermagem Recém nascido Revisão Infant, newborn Nursing care Postnatal care Review Umbilical cord