Processo de cuidado em nutrição em pacientes críticios: criação de instrumento

Abstract

Introduction: Nutritional care in critically ill patients involves many particularities, being essential in clinical management and prognosis. This reinforces the importance of continually seeking improvements in the quality of service provided to these patients. In this context, the Nutrition Care Process (NCP) is a systematic method that aims to resolve nutrition diagnoses and manage the quality of nutrition care offered. Studies have demonstrated benefits of its implementation in clinical practice. However, their application in critical patients is still scarce. Objective: To create a tool for application of NCP in critically ill patients admitted to the Intensive Care Unit (ICU) of the University Hospital Onofre Lopes (HUOL). Methodology: This work was submitted and approved by the HUOL Research Ethics Committee. This is a methodological study on the creation of an instrument, which involved several steps such as holding workshops on the topic, selecting the NCP terminologies (NCPT) and preparing the instrument itself. In all these stages, there was the collaboration of nutritionists experienced in assisting critically ill patients and the existing registration forms from the HUOL nutrition sector were considered. Results: Workshops about NCP were held in 4 phases. In the end, 230 NCPT essential in the care of critically ill patients were selected. A structured and systematized instrument was developed using Microsoft Office Excel® 2016 spreadsheets, in which adata distribution must occur in a linear and continuous manner, organized into three tabs. After inserting all data into the tool, the PCN documentation is automatically generated in ADIMA format (acronym for "Assessment", "Diagnosis", "Intervention", "Monitoring" and "Measurement"). Conclusion: New knowledge about the PCN was built through the workshops held. The selection of NCPT aimed at critical patients will optimize the application of this process and will serve as a comparator for other similar services that will implement the NCP. The tool created will facilitate the implementation of the NCP in the ICU of the HUOL and will allow greater nutrition care documentation in the electronic medical record.