A prática da punção venosa na coleta de sangue em recém-nascidos em um hospital público universitário

Abstract

In the routine care of the newborn, it is possible to notice a wide variety of procedures performed by the health team, and the peripheral venipuncture is considered a practice inherent to this routine. Some professionals face difficulties in venipuncture due to the anatomical structure of the newborns (NB), and to succeed in obtaining the blood sample, those responsible for the collection start using nonstandard procedures. This study aims to describe the materials utilized and the procedures performed by the medical and nursing staff in the use of venipuncture for blood sampling neonates, and to determine the scores of the adherence of these staffs to the guidelines issued by the Ministry of Health (MH), discovering what is the relationship of these scores with their professional traits. This is a sectional descriptive study, with a quantitative analysis. The data collection was carried out between the months of May and July, 2013, by means of an instrument designed, organized and validated specifically for this research, based on the manual used as a reference. Professionals, including technicians and nursing assistants, nurses, pediatricians and pediatric and/or neonatology residents were addressed in their own workspace, and from the 246 (100%) workers, 146 (63%) participated in the survey. Considering the procedure and materials used, what has caught the researchers' attention was the needles used for blood collection. 39 (26.7%) professionals use a needle attached to a syringe; 51 (34.9%) use a common needle (25x0, 07 mm or 25x0, 08mm); 31 (21.2%) use a common needle (25x0, 07 mm or 25x0, 08mm), but break the plastic point of the needle; 11 (7.5%) reported using a needle attached to a scalp/butterfly vein set; and 11 (7.5%) professionals reported using more than one of these types of procedures. Therefore, the procedure used for blood collection via venipuncture was, at some points, divergent from the guidelines prescribed by the MH. Relating to the adherence to the recommended procedure, professionals showed an overall score of 62.69, being the nurses the category that adhered the most to the recommendations, with a score of 67.98 (SD = 7.43).Considering the correlation between the overall score of the adherence to the guidelines and the general professional traits of the health team, only the professional category and the working shifts presented themselves as statistically significant (P> 0.001). Other correlations were virtually nil, and none was statistically significant, indicating that there is a relationship between the variables time and knowledge score. It is concluded that most professionals utilize different procedures than those recommended by the MH, empirically adapting materials in an attempt to facilitate the venipuncture in the NB. Nurses had the highest adherence score, and physicians, the lowest one. It is important to consider that the professionals who were part of this study reported that the procedure they use to collect blood in NB is considered by them the best way to get the blood sample; in spite of that, we reiterate the need of further reflection and further studies on the theme of this work.