Navegando por Palavras-chave "Sistemas De Atenção Psicossocial"

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    Estudo Comparativo No Manejo Da Dor De Pacientes Classificados Como Urgência Relativa Atendidos Em Um Pronto Atendimento De Excelência
    (Universidade Federal de São Paulo (UNIFESP), 2017-02-24) Santos, Marcia Boessio Dos [UNIFESP]; Bohomol, Elena [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Long waiting times at emergency services (ES) increase dissatisfaction and suffering among patients in pain. In these situations, pain management and best practices in nursing are key to ensuring quality care and pain control. Objective: To evaluate the implementation of the Guideline for Antipyretic and Analgesic Administration at Triage (GAAAT) among relatively urgent cases admitted to an ES, based on the indicators arrival-to-discharge time, pain reduction, and user satisfaction. Method: This comparative, prospective cohort study included patients who accepted or declined GAAAT at an ES in the city of São Paulo. All subjects, aged 18 or older, presented with pain and were triaged as relatively urgent cases. The GAAAT and non-GAAAT groups were characterized in terms of arrival-to-discharge time, pain scores at different timepoints, and degree of satisfaction. Results: Of the 185 patients, 55 accepted and 130 declined GAAAT. The most frequent features were female gender, age 31-40 years, higher education, no ES visit during the previous 12 months, and referral to specialized care following triage, albeit without statistical significance. A significant difference (p = 0.004) between groups was observed in analgesic intake before arrival to the ES. No significant difference between the groups was found for mean triage time, medical care, post-triage observation, and subsequent ES stay. However, waiting time until medical care delivery was statistically significant, proving longer for GAAAT-managed than for GAAAT-declining patients (p = 0.03). Significant differences between groups were also observed regarding pain score assigned at triage (p = 0.0001); pain reduction (relative to admission) among those who accepted GAAAT (p = 0.01); fewer analgesics (single dose and type) given during post-triage observation in the GAAAT group (p = 0.01); and pain reduction at discharge (relative to admission) for GAAAT-managed patients (p = 0.02). Pain management proved satisfactory for both groups, but room for improvement was evident. The main reason for declining GAAAT was a preference for medical care, revealing lack of knowledge among users about the strength of protocols. The principal reason for accepting GAAAT was the prospect of pain improvement. Conclusions: No statistical differences were observed in arrival-to-discharge times or patient satisfaction, but pain was better mitigated in the GAAAT group. Nurses should identify patients presenting with pain and take action to manage this symptom during triage, as well as orient drug therapy through continuous evaluation, informed by guidelines validated by the multidisciplinary team. Implementing guidelines designed for the Brazilian healthcare service setting, particularly with support from public policies and professional boards, should result in greater satisfaction among users, irrespective of the principal symptom presented at admission.