Rede de Atenção às Urgências e Emergências: atendimento ao paciente com Acidente Vascular Cerebral Isquêmico Agudo

Abstract

The Urgency and Emergency Care Network works through established flows between services. Patients with acute ischemic stroke need targeted attention, in view of the time-dependent treatment, with few able to have access to adequate treatment and the organization of the health system interferes considerably in the outcome of care. Thus, the thesis sought to answer the question: How is the Urgency and Emergency Care Network organized for the care of patients with acute ischemic stroke in Salvador, Bahia, Brazil? The objective was: To analyze how the care of patients with acute ischemic stroke occurs in the Urgency and Emergency Care Network of Salvador, Bahia, Brazil. Thus, Mário Rovere's theoretical framework on “Health Networks” and the methodological framework of Grounded Theory, by Strauss and Corbin, were used. 75 health professionals, nurses and doctors participated in the study, from the Mobile Emergency Care Service, from two Emergency Care Units and from the Reference Hospital for Stroke, composing three sample groups obtained by theoretical sampling. The interviews took place between October 2019 and October 2020 with the following guiding research question: “Tell me about care for patients with suspected cerebrovascular accident”, allowing data to emerge from the participants' responses. Other questions were raised, from the answers presented, according to the hypotheses listed, until the theoretical saturation of the data. Data collection and analysis took place concurrently and comparatively, allowing for open, axial and integration coding, delimiting the central category: “Revealing the fragmentation in the Urgency and Emergency Care Network in the care of patients with acute stroke ”. Thus, the first article presented in this work points, through the Integrative Literature Review, to the organization of networked care, in view of the agreements between services and the different technologies presented to expand patient care. The second article, entitled: “Urgency and Emergency Care Network: care for patients with stroke” reveals the substantive theory through the categories and subcategories that support the central category. The categories highlight, among other elements, managerial characteristics such as the lack of resources to assist the patient, the incipience of the use of protocols, the absence of language and unique conduct in the network, the patient's departure from the Care Line and care outside the therapeutic window. with assistance limitations. In view of the need for discussion aimed at the interaction of professionals to deepen the communication mechanisms and the restrictive or facilitating elements of care, the third article is presented: “Professional network interaction in the care of patients with stroke” that reveals elements fragmentation in the interaction between services, with facilitating elements from network collaboration being viewed. Thus, there were different levels of interaction in the network, and the discontinuity of the elements that compose it reveals management and planning problems that are urgent for interventions to improve care.