Proposal for the nursing process implementation in the semi-intensive care unit

Abstract

The nursing care system is a way for the nurse to apply their technician-scientific knowledge, characterizing the professional practice. The nurses have been overloaded with bureaucratic activities, spending up to 50% of his/her time collecting, administering and documenting information. The professional practice is difficulty when in the hospitals the relationship between nurse/occupied beds is deficient, causing the challenge: to administer the time accomplishing tasks with quality. This study took place in Semi-intensive Therapy Unit in a philanthropic hospital of the state of São Paulo. Its purpose was to elaborate an instrument for data collection and nursing prescription providing manual registration in an efficient, fast and individualized way. The methodology unfolds in two stages. In the first one, an instrument was elaborated using a database of signs and symptoms. The nurse should underline the detected/observed data. In the second stage, a list of multiple choices was built (checklist) with nursing interventions. It make possible to mark the necessary items to the prescription to be done, and to indicate the appropriate schedule. The instrument reduced in 50% the time to elaborate the nursing prescription and it provided easy use, guaranteeing to elaborate the Nursing Process as the quality/reduction binomial in the record time. This instrument drives at the future development of software to implement the nursing care system.