Construção de protocolo sobre transporte inter-hospitalar de recém-nascido em estado crítico de saúde

Abstract

A quick and safe removal of critical newborns, born in centers without resources, is one of the Ministry of Health recommendations to reduce neonatal mortality from preventable causes. For this, it is necessary to define strategies and approaches towards the execution of a quality transportation. The objective was to build a protocol for inter-hospital transport of newborn(NB) in a critical state of health. It is a methodological study, divided in two phases. The first consisted of integrative review guided by the guiding question: “What are the conducts performed to transport health critically ill NB, to be transported by ambulance, described in scientific publications? ”A this stage data collection took place from May to October 2014 in the databases LILACS, CINAHL, Web of Science and Scopus and PubMED portal by crossing the uncontrolled descriptors newborn transport, neonatal transport, newborn infants, training for newborn transfer in English language databases and controlled: patients’ transport, newborn, neonatal intensive care units and ambulance, in the Portuguese, resulting in 27 articles after applying the inclusion and exclusion criteria. In the second phase, interviews were conducted with 37 health professionals, including physicians, nurses, licensed practice nurses and rescuers drivers active in three health institutions of the National Health System, one maternity in Fortaleza/Ceara, one hospital of the Northern area of the State and Emergency Mobile Service -SAMU in this region. Interview data were analyzed using content analysis, emerging the following categories: planning inter-hospital transport of critical newborn; team for neonatal transportation; preparation for transportation; trajectory followed by NB hospital staff to request the vacancy in another hospital; conducts to be held for transportation of NB; realization of the transport by SAMU. The study respected the ethical principles and was approved by the Ethics Committee of the Federal University of Ceará under number 797 222. The protocol consisted of recommendations to be followed by the hospital staff of origin, destination and the transportation team, seeking the safety and quality of transportation. Guidelines for transportation planning were contemplated, involving: Transportation teams; vehicle; equipment and materials; effective communication and preparation of the NB. Additionally, procedures to be followed for the vacancy request in another hospital; the procedure to be performed before the arrival of the transport team; step by step to send transportation team followed by the Medical Regulation Center of SAMU; preparation of SAMU transport staff and implementing the ambulance transport of advanced support. Through the steps followed to build the protocol, it was observed that the neonatal transportation has been widely investigated in the international arena and that there is a lack of studies in Brazilian context. The protocol built, despite following the universally accepted principles for the success of transportation, needs to be validated for implementation in routine services that execute neonatal transport.