Processo de punção de vasos e trauma vascular periférico na atenção primária à saúde: gerando tecnologia assistencial

Abstract

Research outlined in the Mixed Method Operationalized in five phases: ambience, two sectional studies and two approaches in social representations (structural and procedural). Aimed: 1) To Evaluate the procedure of puncture of vessels and peripheral vascular trauma in the collection of blood samples from the perspective of the users of a Primary Health Care Unit; 2) To understand the social representations elaborated by users regarding the puncture process of blood sampling vessels in the structural and procedural approaches and 3) To produce light-hard assistive technology regarding the puncture of vessels for blood samples collection to perform laboratory tests, based on local evidence of good practices in the puncture process, and applicable to the Units of Primary Health Care. A Primary Health Care Unit of a municipality of Minas Gerais was a research scenario. 417 SUS users participated, 50 in the ambience; 204 in sectional step one and in the approaches of Theories of Social Representations (59 in Processual and all in Structural) and 163 in sectional step two. The theoretical-philosophical references were: Social Representations, Leininger Theories and Peripheral vessel puncture process from the perspective of a communicational activity of reified content. Individual interviews were conducted, containing open, semi-closed and closed questions from a previously validated instrument, with the technique of free evocations from the inducer term. We used the Open Data Kit (ODK) application and questions guided by guiding questions. Quantitative variables were consolidated in Program SPSS24 and treated by descriptive statistics, discursive contents analyzed in the NVivo11 Pro®. Program and evocations treated in the EVOC 2000 Program. Ethical and legal research requirements involving human beings. The specificities of the blood sample collection process were being fast, routine, performed in a mechanized way by nursing technicians professionals and / or nursing students. In the scenario, it occurred with the characteristics of: unfriendly professional / user relationship, centralized in the procedure and in the technicality of the same, impersonal and without the identification of the users' needs. The incidence of peripheral vascular trauma on the day of puncture was 39.3% and 28.2% within 48 hours after the procedure. Two categories express the origin of the collective construction of unpunctured users on the peripheral vessel puncture process: 1) Reified praxis of venipuncture in itself and the others and 2) Reified puncture praxis and the professional-user relationship. The puncture procedure integrates the common sense of the participants and is derived from previous experiences during the contact of their accomplishment with relatives, (un) Known or own experiences. It was identified in the structural approach performed with unpunctured users negative character and absence of an object as a component of the central nucleus, depicting a representation under construction, even before a routine procedure for the participants. Assistance protocols were developed for guidelines for users, professionals and for the evaluation of the puncture site. The way the puncture process of blood vessels takes place requires a re-reading so that individualized care can be obtained and able to meet the singularities of coping with the puncture process of peripheral vessels for the purpose of collecting blood samples. The role of the nurse can impact the reliability of the laboratory results and facilitate the nursing team's performance as a therapist of the process, guaranteeing the empowerment of the SUS user and the quality of the care provided to him in the blood sample collection process for laboratory tests.