Cuidado de enfermagem relacionado à cognição da pessoa idosa na unidade de terapia intensiva

Abstract

The elderly population in Brazil is increasing in an accelerated pace, and elderly have significant hospitalization rates, especially in the Intensive Care Units. The critical environment and the routine within these units are comprised of factors that can impair the maintenance of cognition. Accordingly, interventions guided towards cognitive stimulation in the Intensive Care Units become a priority and the nursing team stands out in the execution of these interventions, once it is the category that has the greatest participation in the care of the elderly patient. With the objective of analyzing how nursing care in relation to stimulating cognition of the elderly patients hospitalized in the Intensive Care Units occurs. A study was conducted a qualitative, descriptive, exploratory study, carried out in two intensive care units of a university hospital located in the city of Salvador-Ba., between December 2019 and February 2020. Data collection occurred in two phases: the first in the patient records of the elderly patients hospitalized in one of the locus units, and secondly from the focal groups with the nursing team. Data analysis was performed using Bardin content analysis and the study complied with the Brazilian standards under Resolution 466/12, having been approved by the Research Ethics Committee. 132 nursing prescriptions, 16 clinical backgrounds, 132 evolutions and 264 nursing notes were monitored. The most identified nursing diagnoses were fall hazard with the related factors: extreme ages (38.9%), neurological impairment (16.7%) and impaired mobility (11.1%); followed by the diagnosis of acute pain: development of the disease (11.1%). Emphasis in the nursing prescription were: sensorial assessment (62.5%) and communicating signs of pain (56.3%). The problems described in the development and notes of the nurses were: monosyllabic verbal contact, having as intervention cognitive stimulation, with aggression to the team, requiring mechanical contention and use of medication. Some of the reported problems did not have any registered interventions. In relation to the focal group meetings, three categories appeared: nursing care related to the cognition of elderly patients in the Intensive Care Units; factors positively influencing nursing care in stimulating cognition of the elderly in the Intensive Care Units and factors negatively influencing nursing care in stimulating cognition of the elderly in the ICU. The results demonstrated that the nursing team performs relevant actions towards stimulating the cognition of the elderly patients in the Intensive Care Units, however, this care is performed in a sporadic manner and poorly recorded. The team needs to raise awareness in relation to this matter and it is indispensable that educational strategies be implemented as well as new studies on the cognition of the elderly in Intensive Care Units.