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Abstract(s)
Enquadramento: A formação avançada cria oportunidades para o desenvolvimento de conhecimentos a um nível de excelência, viabilizando a aquisição de competências técnico-científicas, humanas e éticas, sendo todas essenciais ao desempenho de intervenções autónomas de qualidade, no âmbito da Enfermagem Especializada em Saúde Infantil e Pediátrica (EESIP). O Enfermeiro EESIP deve ser responsável pelo desenvolvimento de práticas de enfermagem baseadas na mais recente evidência científica. Os RNs Prematuros com ventilação não invasiva (VNI) estão sujeitos a diversos estímulos dolorosos que podem interferir com o seu neurodesenvolvimento. A sucção não nutritiva tem sido descrita como estratégia promotora de conforto, mas pouco estudada nos RN em ventilação não invasiva, no sentido de melhorar a eficácia do CPAP.
Objetivos: Descrever as atividades realizadas no decorrer dos diversos contextos de estágio; refletir sobre os contributos do percurso formativo para o desenvolvimento de competências comuns e especificas de Enfermeiro Especialista em Enfermagem de Saúde Infantil e Pediátrica; mapear o efeito da sucção não nutritiva na manutenção e eficácia da ventilação não invasiva em recém-nascidos prematuros, através da realização de uma scoping review.
Metodologia: Foi utilizada uma metodologia critico-reflexiva sobre as ações desenvolvidas nos estágios de Pediatria, Neonatologia e Saúde Infantil e Familiar como forma de refletir sobre as competências comuns e específicas desenvolvidas, inerentes ao Enfermeiro Especialista de Saúde Infantil e Pediátrica (EEESIP), tendo como foco uma temática central. Foi realizada uma scoping review baseada no protocolo proposto pelo Joanna Briggs Institute. Efetuada pesquisa nas bases de dados CINAHL Complete, RCAAP, B-On e PubMed de estudos publicados a partir de 1980, disponibilizados em texto integral e nos idiomas português, inglês e espanhol. Os estudos foram posteriormente avaliados por dois revisores independentes, com base em critérios de inclusão definidos previamente. Dos 210 artigos iniciais, foram incluídos no estudo 3 estudos, após aplicados os critérios de inclusão.
Resultados: O conhecimento científico, relacional e técnico subjacente à prática do cuidar especializado resultou no aperfeiçoamento de competências científicas, técnicas, relacionais e humanas no âmbito do cuidar da criança/jovem e família nas situações de especial complexidade. Da mesma forma, no âmbito do cuidar do recém-nascido de alto risco e sua família, e também no âmbito da assistência à criança/jovem e família, na maximização da sua saúde.
Os resultados evidenciaram que a promoção da sucção não nutritiva nas suas diversas formas enquanto estratégia não farmacológica, utilizada ou complementada com sacarose ou leite materno e ainda ouvir música, promove o conforto do RN prematuro, ao permitir o controlo ou minimização da dor, avaliada por escalas de heteroavaliação, a auto-organização e maior estabilidade do bebé durante a (re)instalação ou manutenção da VNI, melhorando desta forma a sua eficácia.
Conclusão: Da análise reflexiva deste documento considera-se demonstrada a aquisição das competências de Enfermagem Especializada em Saúde Infantil e Pediátrica. Os resultados encontrados na presente scoping review corroboram as evidências científicas que demonstram o efeito benéfico da Sucção não nutritiva enquanto estratégia de conforto e promotora do neurodesenvolvimento, com benefícios na eficácia da VNI.
Palavras-chave: Enfermagem Pediátrica; Recém-nascido; Comportamento de sucção; ventilação não invasiva; Unidades de Cuidados Intensivos Neonatais.
Abstract Background: In advanced training there is the opportunity to develop knowledge at a level of excellence, enabling the acquisition of technical-scientific, human and ethical skills, all of which are essential in the performance of quality autonomous interventions, within the scope of Specialized Nursing in Child and Pediatric Health (EESIP). The EESIP Nurse must be responsible for developing nursing practices, based on the most recent scientific evidence. Sucking is a fundamental basic need for the maturation and development of premature newborns. Premature newborns with non-invasive ventilation are subject to various stimuli in NICUs that can alter their neurodevelopment. Non-nutritive suction is a strategy that promotes neurodevelopment, but it has also been used in clinical practice for other purposes, namely in newborns on non-invasive ventilation, in order to improve the effectiveness of CPAP. Objectives: Describe the activities carried out during the different internship contexts; reflect on the contributions of the training path to the development of common and specific skills as a Nurse Specialist in Child and Pediatric Health Nursing; to map the effect of non-nutritive sucking on the effectiveness and maintenance of non-invasive ventilation in premature newborns, by carrying out a scoping review. Methodology: A critical-reflexive methodology was used on the actions developed in the Pediatrics, Neonatology and Child and Family Health internships as a way of reflecting on the common and specific skills developed, inherent to the Child and Pediatric Health Specialist Nurse (EEESIP), focusing on a central theme. A scoping review was carried out based on the protocol proposed by the Joanna Briggs Institute. A search was carried out in the CINAHL Complete, RCAAP, B-On and PubMed databases for studies published from 1980 onwards, available in full text and in Portuguese, English and Spanish. The studies were subsequently evaluated by two independent reviewers, based on previously defined inclusion criteria. Of the initial 210 articles, 3 articles were included in the study after applying the inclusion criteria. Results: The scientific, relational and technical knowledge underlying the practice of specialized care resulted in the improvement of scientific, technical, relational and human skills in the context of caring for children/young people and families in particularly complex situations. Likewise, in the context of caring for high-risk newborns and their families, and also in the context of assisting children/young people with their families, in maximizing their health. The results showed that the promotion of non-nutritive sucking in its various forms as a non-pharmacological strategy, used or complemented with sucrose or breast milk and also listening to music, promotes the comfort of premature newborns, by allowing the control or minimization of pain, assessed by heteroevaluation scales, self-organization and greater stability of the baby during the (re)installation or maintenance of NIV, thus improving its effectiveness. Conclusion: From the reflective analysis of this document, the acquisition of Specialized Nursing skills in Child and Pediatric Health is considered demonstrated. The results found in this scoping review corroborate the scientific evidence that demonstrates the effect of non-nutritive Suction as a comfort strategy, promoting neurodevelopment and with benefits in the effectiveness of NIV. Keywords: pediatric nursing; preterm newborn; sucking behavior; non-invasive ventilation; Neonatal Intensive Care Units.
Abstract Background: In advanced training there is the opportunity to develop knowledge at a level of excellence, enabling the acquisition of technical-scientific, human and ethical skills, all of which are essential in the performance of quality autonomous interventions, within the scope of Specialized Nursing in Child and Pediatric Health (EESIP). The EESIP Nurse must be responsible for developing nursing practices, based on the most recent scientific evidence. Sucking is a fundamental basic need for the maturation and development of premature newborns. Premature newborns with non-invasive ventilation are subject to various stimuli in NICUs that can alter their neurodevelopment. Non-nutritive suction is a strategy that promotes neurodevelopment, but it has also been used in clinical practice for other purposes, namely in newborns on non-invasive ventilation, in order to improve the effectiveness of CPAP. Objectives: Describe the activities carried out during the different internship contexts; reflect on the contributions of the training path to the development of common and specific skills as a Nurse Specialist in Child and Pediatric Health Nursing; to map the effect of non-nutritive sucking on the effectiveness and maintenance of non-invasive ventilation in premature newborns, by carrying out a scoping review. Methodology: A critical-reflexive methodology was used on the actions developed in the Pediatrics, Neonatology and Child and Family Health internships as a way of reflecting on the common and specific skills developed, inherent to the Child and Pediatric Health Specialist Nurse (EEESIP), focusing on a central theme. A scoping review was carried out based on the protocol proposed by the Joanna Briggs Institute. A search was carried out in the CINAHL Complete, RCAAP, B-On and PubMed databases for studies published from 1980 onwards, available in full text and in Portuguese, English and Spanish. The studies were subsequently evaluated by two independent reviewers, based on previously defined inclusion criteria. Of the initial 210 articles, 3 articles were included in the study after applying the inclusion criteria. Results: The scientific, relational and technical knowledge underlying the practice of specialized care resulted in the improvement of scientific, technical, relational and human skills in the context of caring for children/young people and families in particularly complex situations. Likewise, in the context of caring for high-risk newborns and their families, and also in the context of assisting children/young people with their families, in maximizing their health. The results showed that the promotion of non-nutritive sucking in its various forms as a non-pharmacological strategy, used or complemented with sucrose or breast milk and also listening to music, promotes the comfort of premature newborns, by allowing the control or minimization of pain, assessed by heteroevaluation scales, self-organization and greater stability of the baby during the (re)installation or maintenance of NIV, thus improving its effectiveness. Conclusion: From the reflective analysis of this document, the acquisition of Specialized Nursing skills in Child and Pediatric Health is considered demonstrated. The results found in this scoping review corroborate the scientific evidence that demonstrates the effect of non-nutritive Suction as a comfort strategy, promoting neurodevelopment and with benefits in the effectiveness of NIV. Keywords: pediatric nursing; preterm newborn; sucking behavior; non-invasive ventilation; Neonatal Intensive Care Units.
Description
Keywords
Comportamento de sucção Enfermagem pediátrica Recém nascido prematuro Revisão Unidades de cuidados intensivos neonatais Ventilação não invasiva Infant, premature Intensive care units, neonatal Noninvasive ventilation Pediatric nursing Review Sucking behavior