Protocolo de alta em neonatologia : importância da ação educativa no contexto do cuidado ao bebê pré-termo

Abstract

The admission of a pre-term newborn (PTNB) into a neonatal intensive care unit (NICU) is an event that is translated into a complex experience for families and caregiving team. Training the family to develop abilities and safety to care for the PTNB is one of the Nursing challenges. Therefore, the interventions should be addressed and worked early, during the hospital stay, in order to train the family for the baby care after discharge. Considering that, the objective of the study was to describe the process of a proposal of a discharge protocol for PTNB. It is a descriptive, exploratory research, of qualitative approach that used a convergent assistant research as methodological referential. Participated in the study seven mothers of NBs with gestational age inferior to 37 weeks e birth weight equal or superior to 1,500 grams and that were admitted in a NICU and/or in a Unit of Intermediate Care for a minimum period of 72 hours. Data was collected from October to December 2011 through observing participation, semi-structured and informal interview, carried out in different moments: during NBs hospital stay, during the process of teaching of maternal care for the NB up to discharge, and lately, in meetings in the family's home and at outpatient unit of the University Hospital of Maringá. All data was submitted to Bardin's content analysis. The results showed that the guidance obtained during the baby hospital stay built foundation for the home care. In spite of the preparation process for discharge, doubts persisted for the mothers, at the home. They were doubts about body temperature, bathing and breastfeeding. The study allowed to conclude that, within the proposed discharge protocol, the basic care regarding feeding and hygiene of the newborn became a thematic that required a greater number of educative interventions. Likewise, the organization of topics in thematic groups such as the ones derived from the results of the study - Hands hygiene, General home care, NICU routines, Information about baby's health, Weight gain - among others, served as referential for directing the education approach in these contexts. Another essential aspect for the success of the health educational process refers to the consolidation of an appropriate therapeutic relationship, based on an effective communication, allowing a construction of maternal autonomy to be built in a systematized and effective manner. Thus, the implications of the study for the nursing field knowledge expose the importance of scientific research as an instrument for the diagnosis of the life reality highlighting problems of the quotidian of nurses, and pointing possibilities to systematize caregiving action in different contexts, driven by the search for a certified assistance.