PREVENTION OF PRESSURE INJURIES IN THE PRONATION OF COVID-19 PATIENTS: CONSTRUCTION OF A GRAPHIC NARRATIVE

Daniela Soldera,Lúcia Nazareth Amante,Mônica Stein,Nádia Chiodelli Salum,Cilene Fernandes Soares,Gisele Martins Miranda,Luciara Fabiane Sebold,Juliana Balbinot Reis Girondi

doi:10.30886/estima.v19.1136_in

Abstract

Objective:build and validate the content of a graphic narrative on the prevention of Pressure Injury in the prone position in patients affected by the Coronavirus. Method: descriptive methodological study. For the construction of the graphic narrative, a scope review was carried out. Narrative content validation was performed by nurses working in stomatherapists in respiratory intensive care units in Santa Catarina, who responded to a form on Googleforms® with response options from disagree to agree. Data analysis was performed using the Content Validity Index, considering appropriate > 0.80%. Results: the care listed to compose the narrative were: skin assessment; keeping the skin clean and hydrated; use of pressure redistribution devices; use of silicone foams, transparent films, barrier-forming spray and silicone on bony prominences, under medical devices and on the face. The recommended position is that of the swimmer, repositioning the patient every two hours. Conclusion: the graphic narrative was valid for expert nurses whose emphasis is on preventive care in order to promote the engagement of the Nursing team in the face of the importance of Pressure Injury prevention in the care of patients with Coronavirus and prone.

Highlights

In mid-March 2020, the World Health Organization defined a pandemic situation due to the significant increase in cases of COVID-19, an infectious disease caused by the new Coronavirus (SARS-CoV-2)[1].Patients affected by COVID-19 may be asymptomatic, present mild clinical symptoms, or develop a severe or fatal condition characterized by pneumonia with severe respiratory compromise, requiring hospitalization in the Intensive Care Unit (ICU), evolving with endotracheal intubation, hemodynamic instability and septic shock[2].Among the procedures adopted for the treatment of Acute Respiratory Distress Syndrome (ARDS), the maintenance of the patient in the prone position applied in the first 48 hours, keeping the patient at least 16 hours prone, is considered
This study was structured from the scope review of Nursing care for the prevention of Pressure Injuries (PI) during the prone position in patients affected by COVID-19 and validated by nurses working in the COVID ICU and/or stomatherapists who are experts in skin care, and proceed with the construction of the graphic narrative
Pronation of the patient with COVID-19 helps the treatment of ARDS, it is necessary to remain in this position for up to 16 hours a day, alternating it every 8 hours for the supine position, this position increases the risk of PI14

Summary

Introduction

Among the procedures adopted for the treatment of Acute Respiratory Distress Syndrome (ARDS), the maintenance of the patient in the prone position applied in the first 48 hours, keeping the patient at least 16 hours prone, is considered. Such a condition significantly increases the risk of developing Pressure Injuries (PI) and Medical Device Related Pressure Injuries (MDRPI)[3,4]. It is observed that the Nursing teams, at this moment, are exhausted and, Prevention of pressure injuries in the pronation of Covid-19 patients: construction of a graphic narrative often, skin care and PI prevention may not be being fully developed, either due to lack of time to update this knowledge. It is observed that the Nursing teams, at this moment, are exhausted and, Prevention of pressure injuries in the pronation of Covid-19 patients: construction of a graphic narrative often, skin care and PI prevention may not be being fully developed, either due to lack of time to update this knowledge. or by the work overload, even affecting the emotional lability of these professionals

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Discussion

Conclusion