Efeitos da manipulação excessiva do recém-nascido prematuro em unidade de terapia intensiva neonatal

Abstract

Prematurity is considered a major public health problem, since it is a determinant of neonatal morbidity and mortality, especially in developing countries. The neonatal mortality rate in the Brazilian's NICU is considered high. According to information published by the Ministry of health, premature births in the Brazilian population, has remained constant in recent years, with an average of 6.6%, being variable from State to State, reaching up to 9%, and with a tendency to increase in some cities. With the introduction of Neonatal intensive care units (NICU), and subsequently with the technological advancement, there was a reduction in premature mortality among extreme and very low birth weight. However, the technology that permeates the entire work process in health made the NICU a stressful environment and full of unwanted stimuli for the development of the PN. For the sake of improving his physical condition and monitoring of its pathology, the PN is bombarded constantly by excessive manipulations and technical procedures that can cause damage to their physical and neurological maturation, often irreversible, and could lead to his death. Nursing care and technology are intertwined, leading often to a mechanized and impersonal service, opposed to human and ethical issues. The purpose of this literature review was to know the main actions and\/or interventions that are submitted the PN and identify what are the consequences of this excessive manipulation and what are the sources of stress and stimulation. The method used was the review of the literature, with the search of articles, monographs, theses, journals and books, selected only those inherent to the topic. The final considerations in warning that the responsibility for care when PN is the whole multidisciplinary team, all promote the reduction of excessive handling and stimuli stressors, proposes the adoption of measures of comfort and suggests the implementation of minimum handling protocols, with groupings of care, respecting the individual needs of each one, assessing critically the excessive handling in the most different situations of assistance taking into account the fragility of premature infants. I hope that the work can serve as a basis for others and that will bring benefits to the transformation in health care practice in neonatology, contributing to the awareness of the multidisciplinary team, especially nurses, promoting a change in attitudes and professional attitude, focusing on a more humane and quality care.