Artifacts for the care of users with chronic skin lesions in primary health care based on principles of clinic management
DOI:
https://doi.org/10.33448/rsd-v9i11.10654Keywords:
Inventions; Skin; Primary Health Care; Clinical Governance.Abstract
In this study, it is proposed to produce artifacts for the care of users with chronic skin lesions in primary health care (PHC). Research of an applied nature was undertaken, with a qualitative approach, with theoretical anchoring in principles of clinical management and systematized methodologically based on techniques and tools for experimenting with design. The analysis of the content produced integrates data from an integrative literature review and dialogues in focus groups, involving the multiprofessional PHC team. From this analysis, four thematic categories emerged, in which the respective artifacts produced are presented, with a view to qualifying care in PHC to users with chronic skin lesions: conceptual map, with graphic representation that allows an overview of the team's duties; care algorithm to support clinical decisions, care monitoring and evaluation; briefing that brings together the main therapeutic procedures with minimal resources and / or the option of special coverages fundamental to clinical and social management; and registration structure for the use of standards for monitoring, evaluation and decision support in care actions. The research contributes to the implementation of clinical management principles in PHC services, as it favors the incorporation of evidence-based practices, as well as the orientation of shared and interprofessional clinical actions, based on the needs of users with chronic injuries of skin, and quality and safety standards, focusing on undertaking best practices for the user when meeting the service.
References
Abreu, A. M., & Oliveira, B. G. R. B. (2015). A study of the Unna Boot compared with the elastic bandage in venous ulcers: a randomized clinical trial. Revista Latino-Americana de Enfermagem, 23(4), 571-577.
Alonso-Fernandez, M., Mediavilla-Bravo, J. J., López-Simárro, F., Comas-Samper, J. M., Carramiñana-Barrera, F., Mancera-Romero, J., & Nocito, A. S. (2014). Evaluación de la realización del cribado del pie diabético en Atención Primaria. Endocrinología y Nutrición, 61, 311-317.
Araújo, T. M., Araújo, M. F. M., & Caetano, J. A. (2012). Using the Braden Scale and photographs to assess pressure ulcer risk. Revista da Escola de Enfermagem da USP, 46(4), 858-864.
Barn, R., Waaijman, R., Nollet, F., Woodburn, J., & Bus, S. A. (2015). Predictors of barefoot plantar pressure during walking in patients with diabetes, peripheral neuropathy and a history of ulceration. PLoS One, 10(2).
Bavaresco, A. T., & Lucena, A. F. (2012). Nursing Intervention Classifications (NIC) validated for patients at risk of pressure ulcers. Revista Latino-Americana de Enfermagem, 20(6), 1109-1116.
Bau, A. E. K, & Bonamigo, R. R. (2013). O exame da pele. Em: Buncan, B. et al. Medicina Ambulatorial: condutas de atenção primária baseada em evidências (pp. 1682-1688). 4. ed. Porto Alegre: Artmed.
Bhattacharya, S., & Mishra, R. K. (2015). Pressure ulcers: Current understanding and newer modalities of treatment. Indian journal of plastic surgery, 48(1), 4-16.
Brasil. Ministério da Saúde. (2012). Resolução n° 466, de 12 de dezembro de 2012. Brasília. Recuperado de: bvsms.saude.gov.br/bvs/saudelegis/cns/2013/res0466_12_12_2012.html
Bus, S. A., Waaijman, R., Arts, M., de Haart, M., Busch-Westbroek, T., van Baal, J., & Nollet, F. (2013). Effect of custom-made footwear on foot ulcer recurrence in diabetes: a multicenter randomized controlled trial. Diabetes care, 36(12), 4109–4116.
Cavalcante, M. L. S. N., Moura, A. M. F. T. M., & Carvalho R. E. F. L. (2016). Indicadores de saúde e a segurança do idoso institucionalizado. Revista da Escola de Enfermagem da USP, 50(4), 602-609.
COFEN. Conselho Federal de Enfermagem. (2018). Resolução Cofen n° 0567/2018, de 28 de janeiro de 2018; atuação da Equipe de Enfermagem no Cuidado aos pacientes com feridas. Brasília (DF).
Cooper, H. M. (1982). Scientific guidelines for conducting integrative research reviews. Review of Educational Research, 52(2), 291-302.
Cruz, C. C., Caliri, M. H. L., & Bernardes, R. M. (2018). Características epidemiológicas e clínicas de pessoas com úlcera venosa atendidas em unidades municipais de saúde. Brazilian Journal of Enterostomal Therapy – Revista Estima, 16.
Dantas, D. V., Torres, G. V., Salvetti, M. G., Costa, I. K. F., Dantas, R. A. N., & Araújo, R. O. (2016). Validação clínica de protocolo para úlceras venosas na alta complexidade. Revista Gaúcha de Enfermagem, 37(4).
Duarte, E. R. M., Ferreira, G. E., Richter, S. A., dos Santos, E. P., Kaiser, D. E., & Costa, C. O. (2017). Concepções multiprofissionais sobre a integralidade no cuidado à pessoa com lesão de pele. Enfermagem Brasil, 16(5), 259-266.
Edwards, H., Finlayson, K., Courtney, M., Graves, N., Gibb, M., & Parker, C. (2013). Health service pathways for patients with chronic leg ulcers: identifying effective pathways for facilitation of evidence based wound care. BMC Health Services Research, 13(1), 86.
Ferreira, G. E., Severo, P. C., Richter, S. A., dos Santos, E. P., dos Santos, V. C. F., & Duarte, Ê. R. M. (2018). Gerenciamento do cuidado de enfermagem com lesões de pele no contexto rural: percepções de enfermeiros. Revista de Atenção à Saúde, 16(55), 5-13.
Fonseca, C., Franco, T., Ramos, A., & Silva, C. (2012). The individual with leg ulcer and structured nursing care intervention: a systematic literature review. Revista da Escola de Enfermagem da USP, 46(2), 480-486.
Forlee, M., Rossington, A., & Searle, R. (2014). A prospective, open, multicenter study to evaluate a new gelling fiber dressing containing silver in the management of venous leg ulcers. International Wound Journal, 11(4), 438-445.
Freitas, J. P. C., & Alberti, L. R. (2013). Application of the Braden Scale in the home setting: incidence and factors associated with pressure ulcers. Acta Paulista de Enfermagem, 26(6), 515-521.
Freitas, R. F., Waechter, H. N. Coutinho, S. G., Gubert, F. A., & Beck, F. A. (2016). Contribuições do Grupo Focal à pesquisa de design da informação: percepção dos usuários sobre artefatos impressos da DST/Aids. Estudos em Design, 24(1), 88-103.
Gaspar, P. J. S., & Martinho, P. J. J. (2012). Conhecimentos e práticas de Terapia Compressiva de enfermeiros de cuidados de saúde primários. Revista de Enfermagem Referência, 3(6), 69-79.
Harmsen, M., Gaal, S., van Dulmen, S., & Feijter, E. P. (2010). Patient safety in dutch primary care: a study protocol. Implementation Science, 5, 50.
Januário, V., Ávila, D. A., Penetra, M. A., Sampaio, A. L. B., Noronha Neta, M. I., Cassia, F. F., & Carneiro, S. (2016). Evaluation of treatment with carboxymethylcellulose on chronic venous ulcers. Anais Brasileiros de Dermatologia, 91(1), 17-22.
Junqueira, L. C., Carneiro, J., & Abrahamsohn, P. (2017). Histologia básica: texto e atlas. 13. ed. Rio de Janeiro: Guanabara Koogan.
Kavitha, K. V., Tiwari, S., Purandare, V. B., Khedkar, S., Bhosale, S. S., & Unnikrishnan, A. G. (2014). Choice of wound care in diabetic foot ulcer: a practical approach. World Journal of Diabetes, United States, 5(4), 546-556.
Lima, A. C. B., & Guerra, D. M. (2011). Evaluation of the cost of treating pressure ulcers in hospitalized patients using industrialized dressings. Ciência e Saúde Coletiva, 16(1), 267-277.
Malaquias, S. G., Bachion, M. M., Martins, M. A., Nunes, C. A. B., Torres, G. V., & Pereira, L. V. (2014). Impaired tissue integrity, related factors and defining characteristics in persons with vascular ulcers. Texto & Contexto - Enfermagem, 23(2), 434-442.
Malecky, R., Rosinski, K., & Adamiec. R. (2014). Etiological factors of infections in diabetic foot syndrome – attempt to define optimal empirical therapy. Advances in Clinical and Experimental Medicine, 23(1), 39-48.
Mendes, E. V. (2011). As redes de atenção à saúde. Brasília: Organização Pan-Americana da Saúde.
Menegon, D. B., Bercini, R. R., Santos, C. T., Lucena, A. F., Pereira, A. G. S., & Scain, S. F. (2012). Braden subscales analysis as indicative of risk for pressure ulcer. Texto & Contexto - Enfermagem, 21(4), 854-861.
Minayo, M. C. S. (2016). O desafio do conhecimento: pesquisa qualitativa em saúde. 15. ed. São Paulo: Hucitec.
Mira, J. J., Carrillo, I., & Lorenzo, S. (2017). Qué hacen los hospitales y la atención primaria para mitigar el impacto social de los eventos adversos graves. Gaceta Sanitária, 31(2), 150-153.
Moraes, G. L. A., Araújo, T. M., Caetano, J. A., Lopes, M. V. O., & Silva, M. J. (2012). Evaluation of the risk for pressure ulcers in bedridden elderly at home. Acta Paulista de Enfermagem, 25(spe1), 7-12.
Nicolosi, J. T., Altran, S. C., Barragam, J. P., Carvalho, V. F, & Issac, C. (2015). Terapias compressivas no tratamento de úlcera venosa: estudo bibliométrico. Aquichan, 15(2), 283-295.
Nogueira, G. A., Camac, A. C. L. F., Oliveira B. G. R. B., & Santos, L. S. F. (2015). Caracterização dos protocolos referentes a feridas: revisão integrativa. Revista de Enfermagem UFPE Online, 9(3), 7723-7728.
Padilha, R. Q., Gomes, R., Lima, V. V., Soeiro, E., Oliveira, J. M., Silva, S. F., & Oliveira, M. S. (2018). Princípios para a gestão da clínica: conectando gestão, atenção à saúde e educação na saúde. Ciência & Saúde Coletiva, 23, 4249-4257.
Pazmino, A. V. (2015). Como se cria: 40 métodos para design de produtos. São Paulo: Blucher.
Pereira, A. G. S., Santos, C. T., Menegon, D. B., Mello, B. S., Azambuja, F., & Lucena, A. F. (2014). Mapping the nursing care with the NIC for patients in risk for pressure ulcer. Revista da Escola de Enfermagem da USP, 48(3), 454-461.
Peruzzo, A. B., Negeliskii, C., Antunes, M. C., Coelho, R. P., & Tramontini, S. J. (2005). Protocolo de cuidados a pacientes com lesões de pele. Momentos e perspectivas em saúde. Revista Técnico-Científica do Grupo Hospitalar Conceição, 18(2), 56-69.
Pham, B., Harrison, M. B., Chen, M. H., Carley, M. E., & Canadian Bandaging Trial Group. (2012). Cost-effectiveness of compression technologies for evidence-informed leg ulcer care: results from the Canadian Bandaging Trial. BMC Health Services Research, 12, 346.
Policarpo, N. S., Moura, J. R. A., Melo Júnior, E. B., Almeida, P. C., Macêdo, S. F., & Silva, A. R. V. (2014). Knowledge, attitudes and practices for the prevention of diabetic foot. Revista Gaúcha de Enfermagem, 35(3), 36-42.
Reis, D. B., Peres, G. A., Zuffi, F. B., & Ferreira, L. A. (2013). Care for people with venous ulcers: the perception of nurses in the family health strategy. Reme Revista Mineira de Enfermagem, 17(1), 101-106.
Ren, M., Yang, C., Lin, D. Z., Xiao, H. S., Mai, L. F., Guo, Y. C., & Yan, L. (2014). Effect of intensive nursing education on the prevention of diabetic foot ulceration among patients with high-risk diabetic foot: a follow-up analysis. Diabetes Technology & Therapeutics, 16(9), 576–581.
Rogenski, N. M. B., & Kurcgant P. (2012). The incidence of pressure ulcers after the implementation of a prevention protocol. Revista Latino-Americana de Enfermagem, 20(2), 333-339.
Rüttermann, M., Maier-Hasselmann, A., Nink-Grebe, B., & Burckhardt, M. (2013). Local treatment of chronic wounds in patients with peripheral vascular disease, chronic venous insufficiency and diabetes. Deutsches Ärzteblatt International, 110(3), 25-31.
Sarabahi S. (2012). Recent advances in topical wound care. Indian journal of plastic surgery, 45(2), 379-387.
Scotton, M. F., Miot, H. A., & Abbade, L. P. F. (2014). Factors that influence healing of chronic venous leg ulcers: a retrospective cohort. Anais Brasileiros de Dermatologia, 89(3), 414-422.
Segovia-Gómez, T., Martínez, M. B., & García-Alamino, J. M. (2012). Úlceras por humedad: conocerlas mejor para poder prevenirlas. Gerokomos, 23(3), 137-140.
Sellmer, D., Carvalho, C. M., Carvalho, D. R., & Malucelli, A. (2013). Expert system to support the decision in topical therapy for venous ulcers. Revista Gaúcha de Enfermagem, 34(2), 154-162.
Silva, M. H., Jesus, M. C. P., Merighi, M. A. B., Oliveira, D. M., Santos, S. M. R., & Vicente, E. J. D. (2012). Clinical management of venous ulcers in primary health care. Acta Paulista de Enfermagem, 25(3), 329-333.
Silveira, S., Silva, G., Moura, E., Rangel, E., & Sousa, J. (2013). Pressure ulcers assessment through the pressure ulcer scale for healing application (PUSH). Revista de Pesquisa Cuidado é Fundamental, 5(20), 3847-3855.
Snyder, R. J., Fife, C., & Moore, Z. (2016). Components and quality measures of DIME (devitalized tissue, infection/inflammation, moisture balance, and edge preparation) in wound care. Advances in Skin and Wound Care, 29(5), 205-215.
Tallis, A., Motley, T. A., Wunderlich, R. P., Dickerson Junior, J. E., Waycaster, C., Slade, H. B., & Collagenase Diabetic Foot Ulcer Study Group. (2013). Clinical and economic assessment of diabetic foot ulcer debridement with collagenase: results of a randomized controlled study. Clinical Therapeutics, 35(11), 1805-1820.
Tricco, A. C., Antony, J., Vafaei, A., Khan, P. A., Harrington, A., Cogo, E., Wilson, C., Perrier, L., Wing H., & Straus, S. E. (2015). Seeking effective interventions to treat complex wounds: an overview of systematic reviews. BMC Medicine, 13(1), 89.
Vasconcelos, J. M. B., & Caliri, M. H. L. (2017). Ações de enfermagem antes e após um protocolo de prevenção de lesões por pressão em terapia intensiva. Revista de Enfermagem da Escola Anna Nery, 21(1).
Vassallo, I. M., & Formosa, C. (2015). Comparing calcium alginate dressings to vacuum-assisted closure: a clinical trial. Wounds, 27(7), 180-190.
Vieira, C. P. B., Oliveira, E. W. F., Ribeiro, M. G. C., Luz, M. H. B. A., & Araújo, O. D. (2016). Preventive actions in pressure ulcers carried out by nurses in primary care. Revista de Pesquisa: Cuidado é Fundamental Online, 8(2), 4447-4459.
Waaijman, R., Haart, M., Arts, M. L., Wever, D., Verlouw, A. J., Nollet, F., & Bus, S. A. (2014). Risk Factors for Plantar Foot Ulcer Recurrence in Neuropathic Diabetic Patients. Diabetes Care, 37(6), 1697-1705.
WHO. World Health Organization. (2009). Conceptual framework for the international classification for patient safety (pp. 154). Final Technical Report. Retirado de: http://www.who.int/patientsafety/taxonomy/icps_full_report.pdf. Geneva (SUI): World Health Organization.
WHO. World Health Organization. (2018). Safer primary care expert working group. Retirado de: http://www.who.int/patientsafety/safer_primary_care/en/index.html. Geneva. (SUI).
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2020 Fernanda Peixoto Cordova; Jaine Santin; Andre Phylippe Dantas Barros; Carolina Simões Pereira; Lisiane Manganelli Girardi Paskulin; Êrica Rosalba Mallmann Duarte; Dagmar Elaine Kaiser; Gímerson Erick Ferreira
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.