Construção de um protocolo de cuidados de enfermagem para o paciente grave submetido à manobra de pronação

Abstract

The construction of a Nursing Care Protocol for patients with Acute Respiratory Distress Syndrome (ARDS) in prone position arose from the need to create a supporting tool or guiding framework for differentiated and standardized nursing care practices for critically ill patients in intensive or emergency care settings. Objective: To construct a nursing care protocol for patients with ARDS undergoing prone positioning, based on an integrative literature review. Method: This is a methodological study that produces health technology in the form of a protocol for nursing assistance to patients with ARDS subjected to the prone positioning maneuver, stemming from an integrative literature review. The research development was divided into two phases: First phase - Review; Second phase - Protocol construction. The search for scientific literature was conducted in the following scientific databases: LILACS (BVS), Medline/Pubmed, Scopus, and SCINAHL. The selected articles formed the basis for protocol construction. Second phase: protocol construction. After the integrative literature review (ILR), the most relevant topics for constructing the protocol were defined, encompassing the most indicated nursing care practices in the application of prone positioning that underpinned the development of the nursing care protocol. Results: Twelve studies were selected to compose the sample of this study. The nursing care was divided into topics addressing oxygenation and hemodynamic care, patient positioning, nutrition, neurological assessment, and care for skin and mucous membranes, guiding the construction of the protocol. Conclusion: The RIL provided the definition of adequate nursing care to develop a care protocol based on scientifically grounded evidence, capable of significantly contributing to the care provided to patients. A validation study is suggested to better ensure the practical applicability of the results.