KNOWLEDGE, ATTITUDES AND NURSING PRACTICES ON CARDIORESPIRATORY ARREST IN NEONATAL INTERMEDIATE CARE UNIT: A QUALITATIVE STUDY IN THE NORTHEAST OF BRAZIL

Abstract

Introduction: the cardiorespiratory arrest (CRA) in neonates is rarely a sudden event. It is the result of progressive deterioration of respiratory and circulatory functions, leading to irreversible brain damage and death, if appropriate measures are not immediately taken by professionals with specific knowledge. Objective : to analyze the knowledge, attitudes and practices of nursing professionals on cardiorespiratory arrest in a neonatal intermediate care unit. MethodS : Qualitative study of exploratory and descriptive approach, conducted in October 2012 in Cajazeiras, Paraiba, Brazil. Five nurses and three nurse technicians participated. The instrument used was a structured, adapted and validated questionnaire. Results : the nursing professionals knew the definition and how to identify the early signs and symptoms of CRA and recognized the difference between CRA in neonates and adults. Professionals reported changes in care CRA protocol. The careful handling of the newborn, especially the head and neck and heating prior to resuscitation maneuvers were the main actions reflecting basic knowledge to effect the cardiopulmonary ressucitation (CPR) maneuvers. Referring to the sequence of the CPR, questions emerged. Few professionals knew about the correct sequence of the implementation of CPR maneuvers recommended for infants. 100% (n = 8) of the participants demonstrated to know the Advanced Support technical life in neonatology, held with the presence of a doctor. Turning to the main medications administered during CPR in newborns, the adrenaline was the drug of choice, followed by atropine, bicarbonate and dobutamine. Given the factors that hinder the performance of the nursing staff to the CRA victim, professionals reported insecurity, lack of technical skills, difficulty in practice / performance of certain procedures; deficit of practical / theoretical knowledge and inexperience to act on the steps of CPR. Conclusion : it was found that there is no protocol to guide the nursing team in cases of CRA, since they act in a heterogeneous manner. There is also a lack of knowledge of current clinical protocols, on performing certain procedures, primary assessment and chest compressions, according to the new guidelines proposed by the American Heart Association which may lead to a poor quality of care.