Conhecimento do enfermeiro na identificação precoce da injúria renal aguda em terapia intensiva, emergência e unidade de internação

Abstract

Introduction: Acute kidney injury is a complex disorder, in which the kidneys suddenly fail to concentrate urine, maintain electrolytes, and keep fluid balance. Objective: To evaluate nurses’ knowledge regarding the early identification of acute kidney injury (AKI) in an intensive care unit (ICU), inpatient care unit, and emergency unit. Methods: This is a multicenter, prospective, questionnaire-based study. The study population included 216 nurses from five health care facilities who work in the ICU, inpatient care unit, or emergency unit. Data collection was performed between October 2010 and February 2011 using a survey with 10 questions related to prevention and diagnosis of AKI. Results: Among the nurses who replied, 81.7% gave correct answers regarding the importance of oliguria in the identification of AKI; 57.2% did not correctly identify the clinical manifestations of AKI; 54.6% did not know the correct incidence of AKI in patients admitted to the ICU; 87.0% did not know the mortality rate of ICU patients with AKI; 67.1% incorrectly answered that a small increase in serum creatinine did not have a great impact on mortality rate; 66.8% incorrectly answered the question on measures to prevent AKI; 60.4% correctly replied that the use of loop diuretics is not recommended for prevention of AKI; 77.6% correctly responded that the need for hemodialysis does not necessarily characterize AKI; and 92.4% said they had no knowledge of the Acute Kidney Injury Network (AKIN) classification. Conclusion: The results showed that the knowledge of nurses regarding the early identification of AKI is generally poor. This study highlights the need to develop training programs for nurses to improve professional competence and aptitude in the prevention and detection of AKI.