Avaliação da prática de enfermagem no processo de administração de medicamento intravenoso na pediatria

Abstract

The delivery process of the intravenous (IV) medication, one of the activities of greater responsibility of the nursing team, has a high incidence in child care in urgent and emergency situation. This process is considered highly complex and when not planned, controlled and monitored through indicators is exposed to unpredictable results affecting the quality of care. The objective was to evaluate the nursing practice in drug administration in child trough IV. Exploratory, descriptive, observational, quantitative study. It was developed in the urgency and emergency department in a pediatric referral hospital of the municipal sphere of Fortaleza. The study population consisted of 69 nurses whom participated in the drug administration via IV process that was in work schedules during the study period in the investigated unit. The sample of professionals was composed by 36 licensed practice nurses and 2 nurses. For the number of observations, it was considered the calculation for finite population with a total of 327 observations of intravenous medication delivery process. Interviews were carried out for data collection with the nursing staff and systematic observation of drug delivery process in children via IV. For data collection interviews were performed with the nursing staff and systematic observation by IV drug delivery process in children, considering seven stages, namely: medical prescription reading, hand hygiene, preparation of material and medication , guidance on the procedure, puncture technique and administration of the drug. Such steps have the total 47 shares. The data was stored in a database produced on the Windows Excel 2010 and analyzed according to the literature. The study was approved by the Ethics Committee under CAAE protocol 34651314.7.0000.5054. It was found that in 15% of the observations nursing professionals did not understand the prescription due to illegible handwriting professional. In 78.0% of the time there was no hand hygiene. It was found that all professionals used personal protective equipment (cap and mask), but none used gloves. Among the 327 observations included: peripheral intravenous device most commonly used was the scalp 21 (63.3%); selection of dorsal hand veins arc (83.9%); success on the first attempt of venipuncture (82.6%); explains the procedure for child and /or guardian (5.5%); calms the child (82.6%); performs antisepsis of the skin at the site to be punctured with a swab with 70% alcohol (100%); awaits antiseptic evaporation to then continue the procedure (45.6%); proper disposal of the materials used during the procedure (89.3%); checks the prescription immediately after drug administration (86.8%). It was found unsatisfactory performance in 23 actions by IV drug administration process. Therefore, we suggest the development of training for nursing professionals about medication delivery process.