Conhecimento e prática de enfermeiros de Unidades de Terapia Intensiva sobre injúria renal aguda: avaliação diagnóstica

Abstract

The study’s aim was to evaluate the nurses’ knowledge and practice in the intensive care units on nursing care to patients with acute renal injury. Realized an evaluative and cross-sectional research with 136 nurses from seven large public hospitals in the state of Ceará, which take care of adult public who have haemodialysis as a therapeutic modality. The instrument of data collection was constructed from the integrative review and focus group; validated with ten nephrologist nurses. To evaluate the knowledge, 25 questions on aspects of definition and causes, methods of renal evaluation and nursing care were analyzed. The practice was evaluated through a checklist with 15 items on nursing care in two ways: resolution of the questionnaire by nurses and non-participant observation. The data were organized into tables and graphs according to descriptive and inferential statistics using the Chi-Square, Kruskal-Wallis, Cochran and Friedman tests. The results showed that the age of the nurses ranged from 23 to 68 years; 70 (51,47%) are graduates of private universities; with a graduated time between 1 and 35 years; 83 (61,03%) are specialists and from these, only 50 (36,76%) are intensive care nurses; 72 (52,94%) are cooperative. The mean of the knowledge scores was 4.2. A higher knowledge score was observed in the nurses of the day shift, masters, who studied nephrology discipline throughout the academic trajectory and who did some training or capacitation course in the nephrology area. The best practices were observed with regard to curative; Indication of catheter use; Annotation of the water balance and performance in dialysis intercurrences. There was a statistically significant divergence between the two forms of practice evaluation (p <0,001). When cross-referencing the main socio-demographic and professional variables with knowledge and practice, it was observed that there are statistical relationships between having specialization in intensive care with practice (p = 0,031) and to have taken some discipline in nephrology with knowledge (p = 0,047). It was verified that there is no linear relation between knowledge and practice (p = 0,231). It is concluded that the identification of the knowledge deficit and aspects of the inadequate practice contribute to the construction of institutional policies that prioritize permanent education strategies in the clinical practice of intensive care units. It is fundamental courses and trainings in the hospitals directed to the nurses of intensive care units, given that these are the professionals who execute direct care to clients in renal substitutive therapy.