Perspectiva de atuação dos profissionais de enfermagem na desospitalização de crianças com necessidades de saúde especiais e demandas de cuidados tecnológicos

Abstract

Introduction: Children with special health needs and demands for technological care face prolonged hospitalizations due to the complexity of care, requiring nurses to provide support and extensive action for safe dehospitalization. Objective: To describe the role of nursing professionals in the dehospitalization of children with special health needs and demands for technological care. Methodology: Cross-sectional study. Data were collected between March and June 2023 using a Likert-type online form. Data were analyzed using descriptive statistics in the Statistical Package for the Social Sciences (SPSS) version 21.0. Results: 82 professionals participated in the study, most of them from pediatric intensive care (n=38-46.3%). During hospitalization, practices that promote family autonomy for dehospitalization were: preparation for complications (n=58-70.7%), active participation in care (n=53-64.6%), guidance and training from the beginning of hospitalization (n=43-52.4%) and the integration of routines, religion and culture in care planning (n=35-42.6%). Effective communication with family members was positive (n=42-51.2%) and the overload of bureaucratic activities was negative (n=58-70.7%). The challenges highlighted were: pedagogical support for school activities (n=46-56.1%); visits from other children (n=57-69.5%); and sign language training for hearing/speech impairment (n=70-85.3%). When planning discharge, the lack of an Institutional protocol (n=41-50%), time for training/guidance (n=44-53.6%); absence of a discharge coordinating nurse (60-73.1%) and scale to assess family member competence in care (n=57-69.5%) were the main findings. Conclusion: Nursing work proved to occur significantly through actions to promote the autonomy and readiness of family members for home care. The management aspects of care for the implementation of dehospitalization were the main challenges encountered.