Significando o protocolo de úlcera por pressão como instrumento de qualificação para o cuidado gerencial do enfermeiro

Abstract

The management of nursing care occurs from joint lined between managing and caring in a scene of seek for care quality. Nowadays, nurses have been spent efforts to improve the quality and safety of care provided using strategies such as the application of protocols. In this sense, the protocols for prevention and treatment of pressure ulcers are instruments that make the nurse management process easier, once they allow that nurse manages the care based on scientific evidences, what makes the improvement of care possible. Thus, the object of this study is the meaning of the using of a care protocol during the management of nursing care of pressure ulcers in a university hospital. So, the guiding question of this investigation was: What is the meaning given by nurses to the use of a protocol in the management of care provided to the pressure ulcers? Based on this question, the main objective of this research was to know the meaning of using of a care protocol for nurses in the management of nursing care of pressure ulcers in a university hospital. This is a qualitative investigation, based on the methodological framework of the Grounded Theory, and sustained by the theoretical framework of the Complexity Theory proposed by Edgar Morin. Data collection was performed from July to September 2014 in a university hospital of South of Brazil. We interviewed 22 nurses attending in the adult intensive care unit, in the Medical Clinic II, and in the Cardiac intensive care unit. From the theoretical and mythological frameworks, the looking to the data makes us thinking in the dynamic movement of building categories that support a phenomena based on the complexity of caring human beings. From the process of data codification, the categories that sustain the theory of this study raised. Based on the interconnection of categories, the main phenomena that sustained the Substantive Theory or Theoretical Matrix was: Meaning the pressure ulcer protocol as instrument for improvement of nurse managerial care . Care management through a managerial instrument was reported for nurses as way to improve the health care in a process that includes objectivity and subjectivity, considering simultaneously that human being is singular and multiple, and diverse and single, in context of multidimensionality. In addiction, we highlights that the dynamic and flexible care allows a complex nursing care from a innovation for the care that benefits the workers and patients.