Intervenções de enfermagem para pacientes com dor aguda em unidade de urgência e emergência

Abstract

The presence of pain is a major reason for people worldwide to seek medical help. It is also considered to be the main source of distress and helplessness feelings as compared to any other pathology. When affected by severe pain people tend to seek help in a Hospital Emergency Center, which demands specific intervention from the nursing personnel involved. This study aims at identifying nursing interventions on patients in pain, in an emergency unit. It is a descriptive and exploratory study developed at the emergency unit in the west border of RS state. This study consists of three parts: identification of nursing interventions registered in the patients` records, cross-check mapping of nursing interventions identified in the records following the Nursing Interventions Classification for pain by the NIC, and validation of Nursing Interventions mapped by a focal group. 350 patient ́s records were analyzed. 338 were diagnosed by nurses as having Acute Pain. Medication administration was the only intervention identified in the patient ́s record. This was mapped by intervention to: Make sure patient receives proper analgesic care, which was validated in the third part of the study. The nurses included 13 new interventions: Evaluate the pain as the fifth Vital Sign; checking non verbal indicators of physical discomfort, especially in patients with communication difficulties; use of adequate procedures for correct evaluation an monitoring of the pain to help identify real and potential precipitators (flowchart, records); determine the necessary frequency of patient ́s discomfort evaluation and monitoring of pain, and implementation of pain monitoring plan; check patient ́s interest in taking part in the process, his ability to do that, references, support from family and acquaintances in what refers to procedures and contra-indication when choosing plans for pain relief; choose and implement a set of pharmacological, non pharmacological, and interpersonal procedures; encourage the patient to monitor his own pain intensity and take adequate procedures; investigate the use of pharmacological methods for pain relief by the patient; encourage patient to use adequate pain killers; use pain control procedures before pain becomes severe; guarantee sedation prior to treatment or non pharmacological strategies prior to painful procedures; give accurate information to the family on how patient responds to pain experience, and be aware of the response; make sure patient receives the right sedation. Nursing records should be qualified, once it is a common practice between nurses not to register some of the procedures offered to patients.