Nursing interventions and activities for patients with multiple traumas: An integrative review

Abstract

Purpose

The purpose of this study was to identify nursing interventions and activities for patients with multiple traumas who have variations in physical mobility.

Methods

We used integrative literature review following Whittemore and Knafl method and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses’ guidelines and adopting the Oxford Center for Evidence-Based Classification Medicine – Levels of Evidence. The data collection was carried out between October and December 2019 and updated in May 2022, in the following databases: Virtual Health Library, Cochrane Library, Excerpta Medica dataBASE, Medical Literature Analysis and Retrieval System Online, PubMed®, SciVerse Scopus, The Cumulative Index to Nursing and Allied Health Literature, and Web of Science.

Findings

There were 103 articles to be fully read and evaluated. From these, 34 publications were selected. Most nursing interventions and activities identified were placed in the NIC class Activity and Exercise Management in the Physiological: Basic domain, which has interventions to organize or to assist with physical activity, energy conservation, and expenditure; followed by Elimination Management (interventions to establish and maintain regular bowel and urinary elimination patterns and manage complications due to altered patterns); Immobility Management (interventions to manage restricted body movement and the sequelae); Nutrition Support (interventions to modify or maintain nutritional status); Physical Comfort Promotion (interventions to promote comfort using physical techniques); and Self-Care Facilitation (interventions to provide or assist with routine activities of daily living).

Conclusions

The interventions and nursing activities found in this research were not only related to the change in mobility in victims of multiple traumas but also aimed to prevent the consequences of immobility and to take care of already established conditions.

Implications for the nursing practice

This research enables the taxonomy's development and the validation of interventions for selected groups of patients. This allows the contribution to the development of the NIC—an important resource to improve nursing practice in teaching, research, and care.

Objetivo

Esta pesquisa propõe a identificação das intervenções e atividades de enfermagem para pacientes politraumatizados que apresentam alterações na mobilidade física.

Métodos

Trata-se de uma revisão minuciosa da literatura, seguindo o método de Whittemore e Knafl e as diretrizes Preferred Reporting Items for Systematic Reviews and Meta-Analyses (2005) e adotando o Oxford Centre for Evidence-Based Classification Medicine – Levels of Evidence (2011). A busca na literatura inclui bases de dados da Biblioteca Virtual em Saúde; Biblioteca Cochrane; Base de dados Excerpta Medica; Sistema de Análise e Recuperação de Literatura Médica Online; PubMed®; SciVerse Scopus; O Índice Cumulativo para Enfermagem e Literatura de Saúde Aliada; e Web of Science. As buscas foram realizadas entre outubro e dezembro de 2019 e atualizadas em maio de 2022.

Resultados

Havia 103 artigos para serem lidos e avaliados na íntegra. Destes, foram selecionadas 34. A maioria das intervenções e atividades de enfermagem identificadas foram colocadas na classe NIC Gerenciamento de Atividades e Exercícios no domínio Fisiológico: Básico, que possui intervenções para organizar ou auxiliar na atividade física, conservação de energia e gasto; seguido pelo Gerenciamento de Eliminação (intervenções para estabelecer e manter padrões regulares de eliminação intestinal e urinária e gerenciar complicações devido a padrões alterados); Gestão da Imobilidade (intervenções para gerir o movimento corporal restrito e as sequelas); Suporte Nutricional (intervenções para modificar ou manter o estado nutricional); Promoção do Conforto Físico (intervenções para promover o conforto utilizando técnicas físicas); e Facilitação do Autocuidado (intervenções para fornecer ou auxiliar nas atividades rotineiras da vida diária).

Conclusões

As intervenções e atividades de enfermagem encontradas nesta pesquisa não estavam relacionadas apenas à alteração da mobilidade em vítimas de politraumatismos, mas também visavam prevenir as consequências da imobilidade e cuidar das condições já estabelecidas.

Implicações para a prática de enfermagem

Esta pesquisa possibilita o desenvolvimento da taxonomia e a validação de intervenções para grupos selecionados de pacientes. Isso permite contribuir para o desenvolvimento da NIC – importante recurso para aprimorar a prática de enfermagem no ensino, na pesquisa e na assistência.

Keywords

multiple trauma NIC terminology nursing process patient care planning standardized nursing terminology validation studies

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