cohorte prospectivo que observó adultos en Servicio de Urgencia brasileño, desde indicación hasta uso de la SNG, evaluándose variables clínicas del proceso de trabajo. Se adoptó modelo de Ecuaciones de Estimación Generalizada para identificar factores asociados a demoras en cada etapa del proceso.

Resultados:

el tiempo entre indicación y uso de SNG fue 573 (IQR=360α1093) minutos, en 150 inserciones de SNG. Las inserciones en pacientes que no la utilizaban previamente, demoras en rutina de atención médica, de nutrición y enfermería, uso de ventilación mecánica, noradrenalina y ayuno, constituyeron factores de demora hasta uso de la sonda.

Conclusión:

el tiempo entre indicación y uso de SNG fue elevado, superando las 10 horas en mitad de los casos. Factores relacionados a condiciones clínicas del paciente y a gestión de atención contribuyeron a las demoras.

Descriptores:
Atención de Enfermería; Servicios Médicos de Urgencia; Intubación Gastrointestinal; Tiempo de Tratamiento; Seguridad del Paciente

Conditions	Gross Time (minutes)	p value	Adjusted Time (minutes)	p value
Reason for NET Indication		<0.001		<0.001
Loss of NET at Home^a a Reference range; Gross time derives from univariate analysis, and adjusted time derives from multivariate analysis. Data expressed in “mean±Standard Error” of gamma distribution, in minutes.	28 ± 9		57 ± 24
MV/NIMV	37 ± 6	0.44	70 ± 14	0.53
Malnutrition	72 ± 25	0.05	93 ± 25	0.17
Dysphagia	95 ± 22	<0.001	166 ± 41	<0.001
Loss of Appetite	130 ± 39	<0.001	195 ± 61	0.01
Sensory Impairment	202 ± 49	<0.001	250 ± 54	<0.001
Conditions associated with the work process		<0.001		0.05
Verbal Prescription^a a Reference range; Gross time derives from univariate analysis, and adjusted time derives from multivariate analysis. Data expressed in “mean±Standard Error” of gamma distribution, in minutes.	89 ± 24		72 ± 14
No delay-associated conditions identified	140 ± 35	0.22	105 ± 20	0.56
Prescription not given to the nurse	266 ± 69	<0.001	230 ± 61	0.02
Work shift		<0.001		0.01
Morning (7 am to 1.15 pm)^a a Reference range; Gross time derives from univariate analysis, and adjusted time derives from multivariate analysis. Data expressed in “mean±Standard Error” of gamma distribution, in minutes.	100 ± 14		70 ± 11
Afternoon (1 pm to 7.15 pm)	105 ± 29	0.86	91 ± 20	0.36
Nights (7 pm to 7.15 pm)	429 ± 35	<0.001	269 ± 109	<0.001

Conditions	Gross Time (minutes)	p value	Adjusted Time (minutes)	p value
Clinical test did not indicate NET position in the GIS	Yes: 64 ± 15 Não: 143 ± 96	<0.001	Yes: 29 ± 8 Não: 70 ± 12	<0.001
Loss of NET at home	Yes: 34 ± 11 Não: 143 ± 13	<0.001	Yes: 22 ± 8 Não: 91 ± 10	<0.001

Conditions	Gross time (minutes)	p value	Adjusted time (minutes)	p value
Room of the Emergency Service		<0.001		<0.001
Admission Unita	145 ± 24		71 ± 24
Orange Unit	153 ± 28	0.55	78 ± 22	0.73
Green Unit	202 ± 124	0.61	148 ± 58	0.28
Vascular Unit	405 ± 99	<0.001	199 ± 77	<0.001
Loss of NET at home	Yes 57 ± 6 No 253 ± 39	<0.001	Yes 75 ± 37 No 313 ± 58	0.02

Conditions	Gross time (minutes)	p value	Adjusted time (minutes)	p value
Patients who required NET-administered medication	Yes 196 ± 45 No 293 ± 35	0.13	Yes 118 ± 22 No 180 ± 37	<0.001
Work shift		<0.001		<0.001
Afternoon (1 pm to 7:15 pm)	97 ± 19		98 ± 21
Morning (7 am to 1:15 pm)	538 ± 84	<0.001	231 ± 52	<0.001
Nights (7 pm to 7:30 am)	233 ± 45	<0.001	137 ± 29	0.03
Ventilation		<0.001		<0.001
NIMV^a a Reference range. Gross time derives from univariate analysis, and the adjusted time derives from multivariate analysis. Data expressed in “mean±Standard Error” of gamma distribution, in minutes.	139 ± 44		89 ± 24
Spontaneous	241 ± 36	0.13	140 ± 28	0.07
MV	444 ± 94	<0.001	248 ± 64	<0.001
Continuous Vasopressor	Yes 533 ± 188 No 238 ± 30	0.03	Yes 87 ± 30 No 242 ± 64	0.01
Conditions associated with the work process		<0.001		<0.001
Do not to have conditions associated with delaysa	81 ± 8		61 ± 13
NET postponed by the physician	160 ± 67	0.12	63 ± 19	0.94
Time for sending the first diet by the central kitchen	457 ± 68	<0.001	210 ± 50	<0.001
Diet was not installed	188 ± 95	0.10	234 ± 111	<0.001
Fasting for therapeutic or diagnostic procedures	452 ± 104	<0.001	344 ± 78	<0.001

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] CORRESPONDING AUTHOR: Franciele Anziliero. E-mail: franziliero@hotmail.com