Um retrato de UTI Pediátricas em um recorte transversal durante a pandemia de COVID-19: uma avaliação de estrutura das unidades

Abstract

The interest of this dissertation arose to evaluate Pediatric Intensive Care Units (PICU) in terms of service structure. The study survey was collected from 07/01/2020 to 10/31/2020 through a self-completed questionnaire by the 29 technical responsible physicians and 1084 health professionals working in the unit. The primary objective was to describe and evaluate the suitability of structural aspects of 29 Pediatric Intensive Care Units from seven states in Brazil to the normative regulation that was already in course in Brazil before the pandemic, and to the norms and demands imposed during the pandemic. It is proposed to analyze structure indicators (human resources, protocols, physical structure, guidelines and routines in the pandemic, continuing education and training, and material resources). In the analysis of indicators for verification of adequacy to the regulatory norms, it was evaluated that in the dimension of human resources and protocols, at least one third of the units did not fulfill requirements foressen in the norm. In human resources, the lowest proportions observed were for the category of nursing technicians, diarist doctors and physiotherapists (65.5%, 69.1%, 82.7%). For protocols and routines, there are 55.2% of units that have sepsis sedation and pain protocols installed and current. Despite this lag, already existing, when the suitability for the pandemic’s regulations and demands was analyzed, it was found that the response of the units in the different structural dimensions analyzed was generally better or similar to that observed in studies carried out at that period in Latin America. There were 1084 health professionals interviewed and 60% had personal protective Equipment (PPE) available for assistance in aerosol- generating procedures. Units with private funding had higher proportions of adequacy in human resources for some professional categories during the pandemic such as intensive care physicians (44.8% x 17.2%; p<0.01), and material resources, such as assistance in aerosol-generating procedures (31.3% x 28.8%; p=0.02). The professional category that had the most inadequacy to the regulations for the availability for of PPE (personal protective equipment) was that of nursing technicians (14.4% x 11.3%; p<0.01). What was observed, therefore, was that in the aspects evaluated, the pre-pandemic situation was reasonable, but already with room for improvement, and during the health crisis there was a response comparable to results found in other studies in the region. However, if there had been more efficient management with adequate allocation of resources, it is likely that the reaction would have been better.