Desenvolvimento e validação de um sistema eletrônico de monitoramento de posicionamento e registro de reposicionamento em pacientes com Síndrome de Imobilidade no Leito

Abstract

Introduction: Patients with immobility syndrome are at high risk for developing pressure injuries (PPL), which are injured in regions of bony prominence such as the heel and sacral and trochanteric regions. It is an avoidable adverse event in which the absence of a change in position is the main risk factor, so such patients should be repositioned in bed every two. The signaling about the moment for the repositioning is traditionally done by a diagram of a paper clock fixed at the bedside with the times for the change (passive signaling), which after the act, is manually recorded in the chart. In daily practice, however, there are delays in changing the patient's position and inaccuracies in the medical record, which can lead to an increase in the number of LPP. However, with technological evolution, through the internet of things (IoT), other means of active signaling and instantaneous recording can make this therapeutic act more efficient. Objective: To develop and validate an electronic patient positioning monitoring system in the bed, capable of actively informing about the correct moment of repositioning and automatically recording it. Method: The system was tested and validated in a prospective cohort study in patient’s with immobility syndrome. The assessment of dependence was classified using the Katz Scale, the assessment of risk for the development of LPP by the Braden scale and the assessment of nutritional status by the MAN scale. A comparison was made between the medical records and the system. The perception of patients and nursing staff regarding its use was collected. Results: An electronic device was created, with a monitoring system, called + CARE, portable and used on the patient's clothing. The device monitored the patient's positioning in the bed in real time and actively signaled the need for repositioning. Twelve patients with immobility syndrome were evaluated between December 9 and 18, 2021, of both sexes, with a mean age of 75 years (SD 10.87). Nine patients had a pressure injury, but none developed new injuries. The device accurately monitored body position, actively signaled the need for repositioning and recorded it in real time. It didn't cause any inconvenience and it was easy to understand. Inconsistencies were identified in relation to the record in the medical chart and the care actually performed. There was a difference, non-agreement between the medical records and the device, in nine of the ten days of follow-up. Conclusion: + CARE proved to be validated in monitoring body position, signaling repositioning and recording it. It is a positive innovation with the potential to reduce pressure injuries.