Carga laboral de las enfermeras en Unidades de Hemodiálisis Crónica según dependencia y riesgo de los pacientes

Abstract

(Rev Med Chile 2017; 145: 888-895)

Complicações hemodialíticas na unidade de terapia intensiva

“…22 It was pointed out the prevalence of hypotension as an intradialytic complication in this study, associated with the hemodynamic fragility in the patient and also the primary reflex of the large amount of fluid that is extracted from the plasma volume during a routine dialysis session; the water, which is accumulated in the interdialytic range, is extracted directly by the ultrafiltration mechanism. 23 In this study, arterial hypertension was the second most frequent complication, also reported in another study, since the kidneys stimulate the production of vasoconstrictors and vasodilators. Hypervolemia and the inappropriate performance of the Renin-Angiotensin-Aldosterone System, during hemodialysis, prevent the compensatory mechanism of vasodilation, raising blood pressure in patients.…”

“…5 From this event, the nursing team's conduct during the hemodialysis treatment and the direct care to avoid complications due to arterial hypertension. 23 During hemodialysis, patients with cardiac abnormalities (systemic arterial hypertension, congestive heart failure, hypovolemia, among others) may present a greater disposition to complications, since cardiac arrhythmias may be potentiated due to the circulation extracorporeal therapy of hemodialysis. 4 The need for a vascular access route is added to the hemodialysis procedure, and in this study 69 (88.46%) patients had a double lumen catheter (DLCT), a device generally implanted in regions of deep veins parallel to the proportions joints of the human body, such as jugular, subclavian or femoral veins, most commonly used in patients with indication of short-term treatment, such as in the ICU.…”

“…It is emphasized that the success in the accomplishment of hemodialysis treatment is related to the availability of a Nursing team qualified for this treatment; 23 for this, the nurse who works in the Intensive Care Unit must have decision-making capacity in order to guarantee an effective result of critical patient care and in hemodialysis treatment. 3 It is emphasized that the intensive care provided to critical patients is directly related to the duties of the nurse, both in relation to planning activities, as well as in the decisions that involve the patient 18 and also to the Nursing staff.…”

The system of nursing in Chile: Insights from a systems theory perspective

“…Therefore, and restricting our discussion to actual practices, it would be unsuitable not to consider these subordinate groups as a part of the new caring professions—even if they do not fit local representations of a profession proper—as university‐trained nurses become interested in ‘cleaner’ tasks and organisational roles (Ayala, Vanderstraeten et al., ). Management—that is, mobilising, coordinating and monitoring flows of work while running the wards—occurs away from the bedside more often than not, though it now consumes a great portion of a nurse's day (Ayala et al., ; Barrios et al., ; Seguel, Valenzuela, & Sanhueza, ).…”

Fatores que influenciam a segurança do paciente em hemodiálise: revisão integrativa

“…Constatou-se a necessidade de distribuição dos pacientes durante o plantão, a fim de evitar sobrecarga e estresse para os profissionais, o que pode favorecer a ocorrência de eventos adversos. 15,16 Ao avaliar o ambiente de trabalho nos setores de hemodiálise, pesquisa 17 realizada na Grécia descreveu o enfermeiro como o membro da equipe mais elegível para julgar a eficácia e eficiência de programas de segurança ao paciente. Outros estudos 18,19 enfatizam que a atuação do enfermeiro frente a pacientes com DRC em tratamento hemodialítico, deve incluir o incentivo ao autocuidado, a inclusão da família no processo saúde-doença, além de orientações quanto a prevenção de infecção.…”