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Gestão da dor pelos enfermeiros da triagem no serviço de urgência
| Name: | Description: | Size: | Format: | |
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| Projeto de graduação_43021 | 520.79 KB | Adobe PDF |
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Abstract(s)
Introdução: A dor é definida pela International Association for the Study of Pain (IASP), como uma experiência multidimensional desagradável, envolvendo não só um componente sensorial mas, também, um componente emocional e que se associa a uma lesão tecidular concreta ou potencial, ou é descrita em função dessa lesão (IASP; 2020). Em Portugal, a triagem nos serviços de urgência é realizada por enfermeiros com formação específica no Sistema de Triagem de Manchester, cabendo-lhes a responsabilidade de atribuir prioridades clínicas com base na gravidade dos sintomas apresentados (José, 2019). No entanto, este processo pode ser condicionado por diversos fatores, como a pressão assistencial, o contexto organizacional e a subjetividade de certos sintomas, como a dor, que tendem a ser subvalorizados (Freitas, 2014). Além disso, os próprios profissionais reconhecem que, apesar da estrutura do sistema, há limitações na sua aplicação prática, sendo a perceção clínica do enfermeiro determinante para a eficácia da triagem (Costa, Torres & Sousa, 2022). A ausência ou a escassez de ferramentas e protocolos validados pelas instituições competentes contribui para a desvalorização da dor e para o prolongamento do tempo de espera pela administração de analgesia, o que, por sua vez, intensifica o sofrimento dos utentes (Sampson et al., 2020).
Objetivo: O objetivo desta scoping review é mapear e resumir a evidência científica sobre a gestão da dor pelos enfermeiros da triagem do serviço de urgência.
Critérios de inclusão: Foram incluídos estudos que abordavam a atuação de enfermeiros na triagem em serviços de urgência de adultos. Consideraram-se aqueles que tratavam da avaliação, gestão ou intervenção na dor, bem como trabalhos que descrevessem práticas, estratégias ou protocolos de enfermagem utilizados na gestão da dor durante o processo de triagem.
Critérios de exclusão: Excluíram-se estudos que não focassem a prática de enfermagem ou centrados noutros profissionais de saúde. Foram também excluídos estudos com populações pediátricas, obstétricas ou fora do contexto de urgência para adultos. Eliminaram-se artigos sem texto completo disponível ou redigidos em idiomas não contemplados na revisão.
Métodos Foi elaborada a scoping review de acordo com a Joanna Briggs Institute (JBI). A pesquisa foi realizada em maio de 2025, nas bases de dados MEDLINE®, CINAHL® via EBSCO e na B-ON. Os artigos incluídos foram selecionados com base nos critérios de elegibilidade previamente definidos.
Resultados: Seis estudos sem limitações temporais foram incluídos. Os resultados indicam que os enfermeiros avaliam a dor na triagem principalmente através de escalas numéricas, mas enfrentam dificuldades na comunicação e na administração autónoma de analgesia, o que provoca atrasos no tratamento. Protocolos que permitem a iniciação da analgesia na triagem mostraram reduzir o tempo até à intervenção, melhorar o alívio da dor e aumentar a satisfação dos utentes. A formação e a autonomia dos enfermeiros foram destacadas como essenciais para uma gestão eficaz da dor no serviço de urgência.
Conclusão: A gestão da dor pelos enfermeiros na triagem do serviço de urgência apresenta desafios relacionados com a avaliação precisa da dor e a limitação na administração autónoma de analgesia. No entanto, a implementação de protocolos que autorizam a iniciação precoce da analgesia e a formação adequada dos enfermeiros revelam-se estratégias eficazes para melhorar o alívio da dor, reduzir atrasos e aumentar a satisfação dos utentes. Estas medidas são fundamentais para otimizar a qualidade dos cuidados prestados na triagem de urgência.
Palavras-chaves: As palavras chaves utilizadas serão dor aguda; enfermeiros; gestão da dor; serviço de urgência e triagem.
Introduction: Pain is defined by the International Association for the Study of Pain (IASP) as an unpleasant, multidimensional experience, involving not only a sensory but also an emotional component, and associated with, or described in terms of, actual or potential tissue damage (IASP, 2020). In Portugal, triage in emergency departments is performed by nurses specifically trained in the Manchester Triage System, who are responsible for assigning clinical priorities based on the severity of symptoms (José, 2019). However, this process can be conditioned by several factors, such as pressure from healthcare providers, the organizational context, and the subjectivity of certain symptoms, such as pain, which tend to be undervalued (Freitas, 2014). Furthermore, the professionals themselves recognize that, despite the structure of the system, there are limitations in its practical application, with the nurse's clinical perception being decisive for the effectiveness of triage (Costa, Torres & Sousa, 2022). The absence or scarcity of tools and protocols validated by the competent institutions contributes to the devaluation of pain and the prolongation of the waiting time for the administration of analgesia, which, in turn, intensifies the suffering of users (Sampson et al., 2020). Objective: The objective of this scoping review is to map and summarize the scientific evidence on pain management by emergency department triage nurses. Inclusion criteria: Studies on the perfomance of nurse in screening in emergency services with adult population were included. Studies that addressed the evaluation, management or intervention in pain were considered. Studies that described nursing practices, strategies or protocols in pain management during screening were also admitted. Exclusion criteria: Studies addressing nurses' role in triage in adult emergency departments were included. Studies addressing pain assessment, management, or intervention were also considered, as were studies describing nursing practices, strategies, or protocols used in pain management during the triage process. Results: Six studies without time limits were included. The results indicate that nurses assess pain during triage primarily using numerical scales, but face difficulties in communication and autonomous administration of analgesia, which leads to treatment delays. Protocols that allow initiation of analgesia during triage have been shown to reduce time to intervention, improve pain relief, and increase patient satisfaction. Nurse training and autonomy were highlighted as essential for effective pain management in the emergency department. Conclusion: Pain management by nurses in emergency department triage presents challenges related to accurate pain assessment and limited self-administration of analgesia. However, implementing protocols that allow early initiation of analgesia and adequate nurse training prove to be effective strategies for improving pain relief, reducing delays, and increasing patient satisfaction. These measures are essential to optimizing the quality of care provided in emergency triage. Keywords: The keywords used will be acute pain; nurses; pain management; emergency service and triage.
Introduction: Pain is defined by the International Association for the Study of Pain (IASP) as an unpleasant, multidimensional experience, involving not only a sensory but also an emotional component, and associated with, or described in terms of, actual or potential tissue damage (IASP, 2020). In Portugal, triage in emergency departments is performed by nurses specifically trained in the Manchester Triage System, who are responsible for assigning clinical priorities based on the severity of symptoms (José, 2019). However, this process can be conditioned by several factors, such as pressure from healthcare providers, the organizational context, and the subjectivity of certain symptoms, such as pain, which tend to be undervalued (Freitas, 2014). Furthermore, the professionals themselves recognize that, despite the structure of the system, there are limitations in its practical application, with the nurse's clinical perception being decisive for the effectiveness of triage (Costa, Torres & Sousa, 2022). The absence or scarcity of tools and protocols validated by the competent institutions contributes to the devaluation of pain and the prolongation of the waiting time for the administration of analgesia, which, in turn, intensifies the suffering of users (Sampson et al., 2020). Objective: The objective of this scoping review is to map and summarize the scientific evidence on pain management by emergency department triage nurses. Inclusion criteria: Studies on the perfomance of nurse in screening in emergency services with adult population were included. Studies that addressed the evaluation, management or intervention in pain were considered. Studies that described nursing practices, strategies or protocols in pain management during screening were also admitted. Exclusion criteria: Studies addressing nurses' role in triage in adult emergency departments were included. Studies addressing pain assessment, management, or intervention were also considered, as were studies describing nursing practices, strategies, or protocols used in pain management during the triage process. Results: Six studies without time limits were included. The results indicate that nurses assess pain during triage primarily using numerical scales, but face difficulties in communication and autonomous administration of analgesia, which leads to treatment delays. Protocols that allow initiation of analgesia during triage have been shown to reduce time to intervention, improve pain relief, and increase patient satisfaction. Nurse training and autonomy were highlighted as essential for effective pain management in the emergency department. Conclusion: Pain management by nurses in emergency department triage presents challenges related to accurate pain assessment and limited self-administration of analgesia. However, implementing protocols that allow early initiation of analgesia and adequate nurse training prove to be effective strategies for improving pain relief, reducing delays, and increasing patient satisfaction. These measures are essential to optimizing the quality of care provided in emergency triage. Keywords: The keywords used will be acute pain; nurses; pain management; emergency service and triage.
Description
Projeto de Graduação apresentado à Universidade Fernando Pessoa para obtenção do grau de Licenciada em Enfermagem.
Keywords
Dor aguda Enfermeiros Gestão da dor Serviço de urgência e triagem Acute pain Nurses Pain management Emergency service and triage