Cuidado de enfermagem à criança traqueostomizada nas unidades de terapia intensiva neonatal e pediátrica: pesquisa convergente assistencial

Abstract

Children with tracheostomies require complex and specialized care. Nursing professionals and other members of the multidisciplinary team play a crucial role in this process, which requires constant updating to ensure the best care for these technology-dependent children. This study aimed to develop, together with the nursing team of the neonatal and pediatric intensive care units of a university hospital in the south of Minas Gerais, a nursing care protocol for tracheostomized children in neonatal and pediatric critical care. To this end, the theoretical framework of Social Constructionism and the methodological framework of Convergent Care Research were used. Data collection was carried out through semi-structured interviews, participant observation and convergence groups. The interviews, which were the first stage of this study, were attended by 15 nursing professionals from the neonatal and pediatric intensive care teams and five parents of tracheostomized children admitted to these units. For the interviews with the professionals, a sociodemographic and professional characterization instrument was used with the following guiding question: Tell us about your experience of caring for a child with a tracheostomy. For the parents, a sociodemographic characterization instrument with the following guiding question was used: How has your experience been as a companion to your child with a tracheostomy in this unit? Sixteen professionals from the nursing team of the neonatal and pediatric intensive care units participated in the convergence groups. According to the Convergent Care Research, to support clinical practice and nursing care for tracheostomized children, three convergence groups were developed with 16 participants from the nursing team in each group, with the purpose of developing a protocol and at the same time carrying out educational actions, with active teachinglearning methodologies. The actions were conducted through dialogued exposition, and reflections that incited discussion, thus the educational process was constructed together with the participants. The researcher carried out participant observation and recorded in a field diary. From the inductive analysis of data from interviews, participant observation, convergence groups and field diary records, the following categories were established: “Knowledge and skills needs for safe care” and “Specific care for children with tracheostomy: far beyond procedural techniques and general guidelines” and a Nursing Care Protocol for children with tracheostomy in neonatal and pediatric critical care. The joint construction of a care protocol through Convergent Care Research and Social Constructionism may contribute to motivating the implementation of this technology in neonatal and pediatric intensive care units and produce changes in care practice.