Abstract
ABSTRACT Objective: to relate nursing diagnoses/outcomes and interventions for critically ill patients affected by COVID-19 and sepsis in the Intensive Care Unit, according to the International Classification for Nursing Practice (ICNP®). Method: a documentary study conducted in March and April 2020 from the ICNP® terminology subset for adult patients with sepsis. The documentary corpus was composed of the list of nursing diagnoses/outcomes and interventions based on Horta's Theory of Basic Human Needs; on the 7-Axis Model of the International Classification for Nursing Practice, version 2017; on the Pathophysiological model of sepsis; as well as relying on the authors' expertise in direct care for suspected or confirmed critically ill patients affected by COVID-19. Outcomes: a total of 58 nursing diagnoses/outcomes were identified that belong to the psychobiological needs of oxygenation (13-22.4%), vascular regulation (12-20.7%), neurological regulation (10-17.2%), hydration (08-13.8%), elimination (08-13.8%), immunological regulation (04-6.9%) and thermal regulation (03-5.2%), evidencing a total of 172 nursing interventions with a mean of 03 for each nursing diagnosis/outcome. Conclusion: data analysis provided greater knowledge about the disease and the nursing process in the ICU setting, serving as a guide for the professional practice for critically ill patients hospitalized with COVID-19 and sepsis.
Highlights
Even before the infection by the new coronavirus (SARS-CoV-2) originated a pandemic that had a major impact on the health of the populations and on the economy worldwide, the first cases of this acute respiratory disease emerged in Wuhan, China, at the end of December 2019
The documentary corpus was composed of the list of nursing diagnoses/outcomes and interventions based on Horta’s Basic Human Needs (BHN) Theory; on the 7-Axis Model of the International Classification for Nursing Practice, version 2017; on the Pathophysiological model of sepsis, which opportunely highlights immune dysfunction and bioenergetic insufficiency as important processes in the genesis of the disease; as well as relying on the authors’ expertise in direct care for suspected or confirmed critically ill patients affected by COVID-19
Regarding the 58 nursing diagnoses/outcomes identified for the care of critically ill patients affected by COVID-19 and sepsis, distributed according to Horta’s BHNs, 13 (22.4%) belong to the need for oxygenation, 12 (20.7%) to the need for vascular regulation, 10 (17.2%) to the need for neurological regulation, 08 (13.8%) to the need for hydration, 08 (13.8%) to the need for elimination, 04 (6.9%) to the need for immunological regulation, and 03 (5.2%) to the need for thermal regulation
Summary
Even before the infection by the new coronavirus (SARS-CoV-2) originated a pandemic that had a major impact on the health of the populations and on the economy worldwide, the first cases of this acute respiratory disease emerged in Wuhan, China, at the end of December 2019 (called COVID-19). From the new cases reported in several countries on the five continents, the World Health Organization (WHO) soon declared it as a public health emergency of global interest as it presents high and sustained transmissibility among individuals.[1,2] In this context, the most common signs and symptoms attributed to the clinical syndrome consist of fever, myalgia or fatigue, dry cough and dyspnea, which can be accompanied by lymphopenia, abnormalities in blood clotting or bilateral pulmonary ground-glass opacities on chest computed tomography, responsible for a rapid increase in the number of hospitalizations in Intensive Care Units (ICUs) for the artificial support of the organic functions of those most critically ill patients with severe acute respiratory syndrome (SARS).[2,3,4]. Such efforts must provide an agile and adequate treatment based on the international guidelines of the Surviving Sepsis Campaign (SSC)[7,8,9] and on clinical nursing terminology
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