Risco para lesões do posicionamento cirúrgico decorrentes da posição supina

• Ano de defesa: 2018
• Autor(a) principal: Erica Patricia Souza Caetano
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Minas Gerais; UFMG
• Palavras-chave em Português: Lesão Por Pressão; Posicionamento Do Paciente; Período Perioperatório; Decúbito Dorsal; Posicionamento do Paciente/métodos; Enfermagem; Lesão por Pressão; Fatores de Risco
• Link de acesso: http://hdl.handle.net/1843/ENFC-B9AHDX

Introduction: The surgical positioning is permeated by risk factors that are inherent to the patient and also to the surgical anesthetic process. Objective: To identify the risk score for the surgical positioning injuries in patients in the supine position. Method: Observational, longitudinal, prospective and quantitative approach. Performed in a surgical center of a large Public Federal Hospital in Belo Horizonte (Minas Gerais), with approaches in the preoperative, intraoperative and post-anesthetic phases of the perioperative period. The project was approved by the Research Ethics Committee of the Federal University of Minas Gerais (CAAE 57859416.3.0000.5149), in compliance with Resolution 466/2012 of the National Health Council. Data collection occurred from January to April 2018, through a data collection instrument, which included sociodemographic, clinical and surgical variables. In order to measure the risk of lesions resulting from surgical positioning, the Risk Assessment Scale for Injuries from Surgical Positioning (ELPO) was used. Data were analyzed using the statistical software R (version 3.5.0) and statistical analyzes were performed by Stuart-Maxwell, Chi-Square, Fisher's Exact and Multivariate Logistic Regression tests, considering significance level of 5% and interval confidence intervals of 95%. Results: The sample consisted of 89 adult patients. The majority of females, mean age of 49.6 ± 18.1 (19-85 years), rated by American Society for Anesthesiologists (ASA) equals II. The majority presented some comorbidity, with emphasis on Systemic Arterial Hypertension and Diabetes Mellitus. The highest frequency of procedures occurred in the abdomen and pelvis region, submitted to general anesthesia, with surgical anesthetic time between two and four hours. Regarding the risk of lesions due to surgical positioning, 46.1% presented ELPO score> 19, that is, at a higher risk for the development of lesions due to surgical positioning. The mean value of the score was 19.1 ± 2.2 (15-27). Regarding the intervening factors on the ELPO score> 19, statistical significance was found for BMI, age, comorbidities, surgical region, physical status classification and the final adjustment model showed that age was the risk factor for greater intervention for the ELPO score> 19. Regarding the complications, statistical significance was found for pain, erythema region in other sites and erythema in the sacral / coccygeal region, and were classified as Stage I Pressure Injury. Conclusion: The results of this research allowed us to conclude that the risk factors that intervened in the ELPO score> 19 were Body Mass Index (obesity), age, comorbidity (Systemic Arterial Hypertension), surgical region (abdomen and pelvis), classification of the physical state (ASA II), the main being age. The most frequent complications associated with supine position were Pain and Pressure Injury, stage 1. Although the supine position is the most frequent and relatively simple, it does not exempt the patient from the risk of injury. The ELPO scale is a nursing tool that helps the individual and safe care plan to prevent perioperative positioning injuries.