Avaliação do cuidado do enfermeiro em transplante de células tronco hematopoética: estudo metodológico

This study addresses the evaluation of nurse care for patients submitted to hematopoietic stem cell transplantation (HSCT), through the use of indicators. hematopoietic stem cell transplantation (HSCT) is used as a form of treatment in malignant and non-malignant diseases. Nursing care for patients submitted to TCHT is complex and It is based on Doran's concepts of the role of nurses, the structure variables (nurses, patients and organization) of the process (independent, dependent and interdependent nursing interventions) and the result (indicators of the evolution of the problem or the patient's symptom). The evaluation of results is an important indication of the effectiveness of the care provided by nurses. General objective: To build an evaluation matrix through indicators of the evaluation of nurse care in HSCT. Specific objectives: To identify nursing care in HSCT in the literature. Elaborate the indicators directed to the care provided by the nurse to the patient submitted tcht. Discuss the use of indicators for evaluating the care of the NURSE HSCT The justification for this study is the fact nursing management involves, among other things, the decision-making capacity, and it is necessary to use tools, such as the evaluation of nurse care through the use of indicators, to improve the care provided by nurses to patients undergoing HSCT; the elaboration of indicators is a strategy to assess the quality of care, manage results, provide subsidies for the evaluation of services and decision-making by managers; be in the Agenda of Health Research Priorities that points to the need for research aimed at the development of models of health technology management for health care facilities. The evaluation of the sensitive results of the nurse's intervention can contribute by bringing the empowerment of the profession transforming the practice of nursing care, being the social and scientific impact. Objective monitoring of the quality of nurse care through indicators can increase the quality of care provided by reducing costs through prevention, detection and early interventions of complications arising from HSCT reversing in impact for the patient and economic for the institution. The theoretical framework used was the Nursing Role Effectiveness Model (NREM) for Health Quality Assessment. Method: methodological study developed in two stages: the first stage with a scope review and the second with the indicators selected for evaluation of specialists. Survey approved CAAE 87445818.0.00005243. Results: The care of nurses who emerged from the scope review are separated according to the transplantation phase: conditioning, infusion, grip and post-transplant. Twelve indicators were developed that had their validity confirmed through a panel of experts (Delphi), with a percentage of agreement of 100% for 07 indicators. An indicator was excluded because it did not present consensus. The kappa coefficient ranged from 0.956 to 1.00, with an excellent degree of agreement among the specialists and being statistically significant (p-value <0.001). Conclusion: the specific knowledge of the care provided by the nurse to the patient submitted to HSCT allows recognition of complications of this clientele and early interventions aimed at the reestablishment of the individual and there is a relationship between the structure variables (nurse, patient, institution) with the process and the result achieved. They confirm the thesis that there is a relationship between the structural variables of the organization, of the patients, of the nurses with the process variables and the health results provide a structure to guide the evaluation of the results of nursing care