Tomada de decisões de enfermeiras no acolhimento com classificação de risco em unidade de pronto atendimento

Abstract

Nurses’ decision-making is a constant action in their professional performance, in particular in the Embracement with Risk Classification, in which the decision needs to be ethical, and targeted by the clinical condition of users seeking the Emergency Care Units of the Unified Health System. The objective of this study is to understand the process of decision-making of nurses in the Embracement with Risk Classification in an Emergency Care Unit. This is a descriptive study with a qualitative approach, which had as participants 19 nurses who worked in an Emergency Care Unit in Salvador, Bahia, Brazil. The instrument for data collection, a Google Forms online questionnaire was used in two parts: Characterization of research participants and nurse’s decision-making in the Embracement with Risk Classification in the Emergency Care Unit. Data collection occurred in the period from 07 June to June 27, 2021 and was organized according to the six steps of the humanist-existential-personist triad configuration, with a reasoned analysis in the interpretation of the content described by the participants, associated with the ethics and bioethics, the nurse’s decision-making, as well as manuals and ordinances of the Ministry of Health. Ethical aspects were guaranteed based on Resolution 466/2012 of the National Health Council. The research project was approved by the Ethics Committee of the Nursing School of the Federal University of Bahia Caae n. 44202721.0.0000.5531. From the analysis, three empirical categories emerged: Nurse's decision-making in the Embracement with Risk Classification; Humanized care of nurses in the Embracement with Risk Classification; Nurse's decision-making in the Embracement with Risk Classification to the user with suspected Acute Myocardial Infarction. The study allowed identifying that nurses acting on Risk Classification make programmed and non-programmed decisions, which are based on institutional protocols/flowcharts, qualified listening, in the objective and subjective data of users and technical-scientific knowledge they have, to identify the severity and, consequently, the clinical priority of each patient. Moreover, nurses, when caring for a user with suspected Acute Myocardial Infarction, make decisions based on the main complaint, signs and symptoms, vital signs, Infarction protocol and classify the risk of this patient as yellow, orange and/or red. The findings of this study showed that nurses exercise a quality care practice in their daily life, through respect, humanization, ethics and responsibility to users met in an Emergency Care Unit.