Profile of children and teens attended in emergency according to the risk classification: a documental study

Abstract

Objective: Outline the clinical profile of children and adolescents (0-14 years) treated at a hospital in Fortaleza, Ceará, based on the criteria of a ACCR protocol in Pediatrics. Methods: Documental study, with a sample of 627 reports of emergency randomly selected, processed and analyzed in SPSS 17.0. Results: Most of the children proceeded from the Regional Executive Office III (65.63%), male (57.33%), aged 1 to 5 years (51.63%) and adequate weight (53.42%). There was an association between risk assessment and the specialty clinical medicine (p <0.001), with the highest percentage rating from yellow to blue in medical clinic. The prevalent complaint was fever with yellow classification. Conclusion: By means of risk rating, the nurse can identify the degree of clinical commitment of patients, the appropriate and exceeding demand of the institution, providing the necessary care, according to the level of complexity of each case.

Classificação de risco em pediatria: construção e validação de um guia para enfermeiros

“…Inadequacy of the demand for care in pediatric emergency services is a reality in many countries and in almost all Brazilian states. Studies shows that the number of patients presenting health problems that could have been solved in the basic care network ranges between 46.9% and 89% (1)(2) .…”

“…Aiming to ensure better quality of care in emergency hospitals, the Ministry of Health, through the National Humanization Policy, implemented the User Embracement with Risk Classification (ACCR -Acolhimento com Classificação de Risco) strategy, in which nurses embrace patients by means of qualified listening (3)(4)(5) , identifying urgencies and emergencies based on the assessment of physiological parameters and warning signs set by protocols (3) and prioritizing the most severe cases (1) .…”

Avaliação das competências de enfermeiras para a promoção em saúde durante atendimentos pediátricos em unidade de emergência

“…This finding does not agree with a previous study if the clinical profile of children according to risk classification, which reported a high prevalence of yellow followed by green. (6) One of the nurse's activities in emergency units is intake with evaluation and classification of risk, so training for this activity is fundamental, as is appropriate classification of the child (one of the competencies of the nurses who work in this environment). Consequently, evaluating the development of these competencies through guided actions based on the health promotion domains in the Galway consensus (catalyzing change, leadership, assessment/diagnostic, planning, implementation, evaluation, advocacy, and partnerships) allow professional practice to be strengthened and assured.…”

“…(5) Along these lines, studies indicate the importance of using simple and easy-to-manage instruments in approaching patients in order to improve the work process in health, especially at health promoting hospitals. (6) Therefore, nurses in pediatric emergency units need to use these technologies efficiently. Among these, the risk classification in pediatrics guide, which was constructed and validated to support the development of competencies in real practice, stands out.…”

“…Among these, the risk classification in pediatrics guide, which was constructed and validated to support the development of competencies in real practice, stands out. (6) In the emergency unit a nurse conducts multiple actions based on professional competencies with the aim of assuring individualized and humanized care. Consequently, the competencies indicate the professional's actions within their work reality, impacting their actions and decisions, so developing more competencies in practice is essential to constructing qualified and integral care.…”