Management of severe preeclampsia in the puerperium: development and scenario validation for clinical simulation.

Samyla Carla Nóbrega Silva,Laiane Medeiros Ribeiro,Casandra Genoveva Rosales Martins Ponce De Leon,Alecssandra De Fátima Silva Viduedo,Beatriz Rodrigues De Alencar,Juliana Machado Schardosim

doi:10.1590/0034-7167-2020-0445

Abstract

to develop and validate a scenario for clinical simulation in nursing education on the management of severe preeclampsia in the puerperium. methodological study in five stages (overview, scenario, scenario design progression, debriefing and assessment), developed from March to December 2019, involving 10 volunteers (one professor, five actors and four judges). Data were analyzed using descriptive statistics and Content Validation Index. the scenario was built from the definition of learning objectives that meet the needs of nursing education. From the completion of a Likert scale, by the judges in on-site validation, a Content Validity Index of 1.0 was reached, which indicates 100% agreement in the assessed items. the scenario was validated. It is expected that teaching by simulation will be expanded and that new studies of scenario validation will contribute to the preparation of future nurses, based on the most recent scientific evidence.

Highlights

Gestational hypertensive syndromes are one of the main causes of maternal morbidity and mortality in the world and in Brazil, in addition to causing significant fetal complications such as prematurity, restricted intrauterine growth and even intrauterine fetal death[1]
According to the clinical picture evolution, blood pressure changes in pregnancy can be classified as gestational hypertension, preeclampsia, eclampsia, HELLP syndrome, and preeclampsia superimposed on chronic hypertension
The puerperium represents a delicate period that requires a lot of attention from the health team that assists these mothers, as there may still be worsening of hypertension, seizures and other clinical changes such as coagulation problems[2,3]

Summary

Introduction

Gestational hypertensive syndromes are one of the main causes of maternal morbidity and mortality in the world and in Brazil, in addition to causing significant fetal complications such as prematurity, restricted intrauterine growth and even intrauterine fetal death[1]. According to the clinical picture evolution, blood pressure changes in pregnancy can be classified as gestational hypertension (when there is only increased blood pressure), preeclampsia (when there is proteinuria associated with hypertension), eclampsia (when seizures occur), HELLP syndrome (when there are changes in liver and coagulation tests), and preeclampsia superimposed on chronic hypertension (when there is proteinuria or other changes in pregnancy of a chronic hypertensive woman). The puerperium represents a delicate period that requires a lot of attention from the health team that assists these mothers, as there may still be worsening of hypertension, seizures and other clinical changes such as coagulation problems[2,3]. As a professional qualified to monitor prenatal care for habitual risk and attention to childbirth and the puerperium, need to be prepared to recognize and properly refer the pregnant woman to follow-up in a specialized prenatal service. Nurses, as leaders of the nursing team, plan and conduct nursing care to keep the patient stable and with minimal associated repercussions[4]

Results

Discussion

Conclusion