Treatment of skin lesions in newborn children: meeting the needs of nursing staff

Abstract

Treatment of skin lesions in newborn children: meeting the needs of nursing staff RESUMEN Objetivo: Conocer, junto al equipo de enfermería, los cuidados necesarios para el tratamiento de lesiones de piel en recién nacidos internados en una Unidad Neonatal. Método: Investigación cualitativa del tipo Convergente Asistencial. Los datos fueron obtenidos por medio de entrevistas semiestructuradas, realizadas en los meses de noviembre a deciembre de 2012, en la Unidad Neonatal de un hospital del Sur de Brasil. Participaron de la investigación cuatro auxiliares de enfermería, seis téc-nicos de enfermería y cuatro enfermeras. Resultados: Se originaron tres categorías: dudas acerca de lo que se puede utilizar en el recién nacido; la estancia hospitalaria puede causar lesiones en la piel del recién nacido; y el conocimiento del cuidado promueve autonomía profesional. Conclusión: Se hace urgente la necesidad de conocimiento del equipo acerca del tratamiento de las lesiones, a fin de proporcionar una atención más segura al recién nacido y favorecer la autonomía del profesional enfermero en la puesta en marcha del cuidado. DESCRIPTORES ABSTRACTObjective: to understand, together with nursing staff, the care needed to treat skin lesions in newborn children hospitalized in a neonatal unit. Method: qualitative research, of the convergent care type. The data was collected through semi-structured interviews, which were conducted from November to December 2012, in the neonatal unit of a hospital in southern Brazil. The participants were four auxiliary nurses, six nursing technicians and four nurses. Results: the following three categories were designated: questions about what can be used in relation to newborn children; hospitalization can cause lesions on the skin of newborn children; and knowledge about care promotes professional autonomy. Conclusion: there is an urgent need for staff to know more about the treatment of skin lesions, which would provide safer care for newborn children and would also support the autonomy of professional nurses in providing that care.

Ocorrência de eventos adversos em Unidade de Terapia Intensiva Neopediátrica: qualidade assistencial de enfermagem

“…Eventos como lesões de pele são portas de entrada para microrganismos, podendo levar até mesmo à septicemia. 17 A etiologia das úlceras de pressão também é multifatorial. Entre os fatores predisponentes mais comuns em neonatologia estão: pressão constante, mau posicionamento, imobilidade ou interferência na mobilidade ou na diminuição de movimentos; pele frágil, debilitada ou desvitalizada, umidade, circulação debilitada, falta ou perda de gordura subcutânea, fricção e edema.…”

Patient safety in the prevention and care of skin lesions in newborns: integrative review

“…Small amounts of 0.5% alcohol chlorhexidine are recommended. Aqueous chlorhexidine prevents chemical burns and is recommended for use in extreme preterm infants (1) . 6…”

“…The newborn's (NB) epidermal barrier begins to form in the womb and its histological development is complete at 34 weeks of gestation. At birth, the stratum corneum of newborn children resembles that of adults, while in the preterm newborn (PTN) there are few layers of stratum corneum and the cells are thinner (1) .…”

“…Both full-term and preterm infants offer greater predisposition to skin lesions due to increased permeability, which causes greater water loss, electrolyte and temperature disturbances, and greater exposure to environmental irritants and infectious agents (1) . Linked to these factors, hospitalization in Neonatal Intensive Care Units (NICU) is a highly complex care scenario, which involves high risk to the patient due to the physiological and hemodynamic instability of the newborn and the characteristics and diversity of procedures performed, which requires continuous patient monitoring to avoid breach of care safety (2)(3) .…”

Potencialidades e limites da autonomia do enfermeiro em ambiente hospitalar

“…It is described, through authors, that autonomy is potentialized not only in theoretical knowledge, but in resolutive action in complex situations and in decisionmaking capacity. 14 Still, studies 10,13,18 point to knowledge as the propellant of autonomy. Knowledge of the activities developed is considered a positive factor to enhance professional autonomy, since it is considered as the basis for the care and trust of the team.…”