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Como no podía ser de otra forma, antes de final de año nuestro equipo se quiere despedir de la mejor forma posible, con noticias muy positivas.

El título de esta entrada nos sugiere un concepto que debería ser esencial para ofrecer los mejores cuidados a los niños en riesgo de padecer UPP o que ya las padecen.

Pero no solo UPP también hablamos de todas las lesiones relacionadas con la dependencia (LRD), pues la gran mayoría de niños en riesgo suelen ser niños con un nivel mayor de dependencia que la fisiológica para su edad. Hacemos referencia a los niños hospitalizados o con diversidad funcional, especialmente aquellos que tienen una falta de movilidad notoria.

Una Enfermera especialista en pediatría es la que tiene las competencias para prevenir las LRD en esta edad. Tal y como refiere S. Bernárdez Carracedo en su artículo «Mejor unidos: pediatra y enfermera especializada»: la enfermera pediátrica  puede: «Valorar de forma integral y contextualizada al recién nacido, al niño, al adolescente y a su familia, detectando cualquier anomalía y posibles déficits en sus necesidades, elaborando juicios clínicos profesionales, planificando las intervenciones y resolviendo de forma autónoma los problemas identificados y/o derivando a otro profesional.»

Soluciones a medida. Fuente: Dr. Pablo García-Molina

Pero hoy además os traemos una buena noticia como última entrada del año y como resumen del camino que es necesario tomar. Esa buena noticia no es otra que la publicación de una tesis doctoral con título «The Impact of Nursing Interventions on Pediatric Pressure Injuries» cuya autora Charleen Deo Singh defendió y publicó en mayo de 2017 en la Universidad de Walden (Estados Unidos de Norteamérica). A continuación mostramos un resumen de este trabajo que le permitió adquirir el título de Doctora en Filosofía en Ciencias de la Salud.

A pesar de que hay múltiples métodos disponibles para disminuir las UPP en pediatría ninguno de ellos ha demostrado una efectividad clara en la reducción de este efecto adverso. Un método específico a utilizar son los paquetes (estrategias) de prevención de UPP pediátricas, que incluyan la rotación de los dispositivos, la gestión del exceso de humedad, el posicionamiento, la evaluación de la piel, el manejo de la presión mediante los cambios posturales y las SEMP. La autora refiere que aunque este tipo de paquetes de prevención están disponibles en todo el país, no se sabe si este método combinado ayuda a disminuir las lesiones por presión en los niños hospitalizados. Para dar respuesta a este dilema  la autora utilizó datos secundarios procedentes del registro de las intervenciones de enfermería implementadas en cada una de los hospitales pediátricos. Se utilizaron los registros de las acciones del paquete preventivo, así como las tasas de UPP. Se investigó el impacto del paquete de prevención sobre las tasas de UPP a lo largo del tiempo y se analizaron de forma separada cada intervención en el paquete de tratamiento.

Al final la muestra incluyó a 102 hospitales pediátricos que participaron en una iniciativa denominada «Solutions for Patient Safety» (Estados Unidos de América).

Fuente: http://www.solutionsforpatientsafety.org/

Se encontró una relación inversa significativa entre las intervenciones de enfermería y las tasas de UPP para los niños hospitalizados. Los resultados indicaron una reducción del 57% en las tasas de UPP durante 5 años gracias a la participación de la enfermería en la implementación del paquete de prevención de UPP en pediátrica. Ninguna de las intervenciones revisadas por separado mostró tener un impacto significativo. La autora concluye que ha observado un cambio social positivo en la capacidad de disminuir las UPP en los niños hospitalizados mediante la implementación de paquetes pediátricos de prevención liderados por enfermeras pediátricas.

Está claro que la autora no encontró una prueba definitiva sobre qué intervención reducía más las UPP en pediatría, pero sí observó que si las enfermeras pediátricas se inmiscuyen en la puesta en marcha de paquetes de prevención que tengan valoración del riesgo, valoración de la piel, control del exceso de la humedad, posicionamiento y manejo de la presión, las tasas de UPP se reducen de forma drástica. Ahora bien, intervenciones individuales o acciones aisladas no han demostrado mayor evidencia que la realización de medidas preventivas conjuntas.

En definitiva, y a la espera de nuevas evidencias científicas es necesario seguir investigando para encontrar las mejores herramientas que eviten las UPP en pediatría, así como que permitan el mejor cuidado de las heridas en niños que las padezcan.

El año próximo tendremos excelentes noticias porque, desde el grupo científico upppediatria.org seguimos trabajando para poder ofreceros recursos útiles para aumentar la detección de niños en riesgo, aumentar las medidas preventivas y los recursos docentes y formativos. Todo ello potenciado con las continuas alianzas que este año 2017 ya realizamos con otras asociaciones de gran nivel y que el año que viene seguirán sumando a este proyecto:

  1. ULCERAS. NET
  2. SOCIEDAD ESPAÑOLA DE ENFERMERÍA NEONATAL (SEEN)

Gracias por seguirnos en las redes sociales y gracias por seguir potenciando el papel de los profesionales sanitarios en evitar las UPP en la población pediátrica y neonatal.

Dr. Pablo García-Molina

Editor: José Antonio León Mangado (Enfermerapp)