Sistematização das condutas da equipe multiprofissional na prevenção e tratamento da intolerância à dieta enteral no paciente em estado crítico

Abstract

Critically ill patients present high catabolism and nutritional therapy (NT) plays an important role in their clinical evolution. However, it is a challenge to nourish them due to several factors, including gastrointestinal intolerance. Objective: Develop, validate and implement an instrument to systematize the team's conduct in relation to the prevention and treatment of intolerance symptoms to enteral feeding. Methods: The study was divided into 6 steps: 1. Construction of a flowchart with procedures for preventing and treating signs and symptoms of enteral diet intolerance, based on the main guidelines that deal with the topic. 2. Construction of a questionnaire with questions about the flowchart. 3. Validation of instruments through evaluation by expert judges on the topic. 4. Application of the questionnaire to the unit’s professionals. 5. Training for the team on the flowchart. 6. Application of the post-training questionnaire. Results: All questions in the questionnaire had a CVC greater than 0.8, whereas for the flowchart, in the part about diarrhea, the CVC was <0.8, with a suggestion to remove Sacharomyces boulardi from the ducts, with the item being maintained after adjustment. Training for the team was carried out in a workshop format and, from the application of pre- and post-training questionnaires, it was observed that team got more answers right after training. Conclusion: The construction, validation and implementation of instruments to assist in clinical practice are very important, as they help in the systematization of conduct, in addition to being an effective way to increase the team's knowledge.