Manejo y control del síndrome de abstinencia neonatal

Abstract

Objetivos: Dada su importancia, se pretende elaborar un protocolo estandarizado que sirva de guía a los enfermeros que trabajan en Unidades de Neonatología. Metodología (material y método): Se ha realizado un trabajo documental sobre el síndrome de abstinencia neonatal y se ha utilizado el proceso enfermero como instrumento para la realización del protocolo. Los Diagnósticos utilizados responden a la nomenclatura según la (NANDA)1 North American Nursing Diagnosis Association. Las intervenciones de enfermería están reflejadas según la clasificación (NIC)2 Nursing Interventions Classification y la evaluación de resultados según la clasificación (NOC)3 Nursing Outcomes Classification, que trata de controlar los resultados tras las distintas intervenciones de manera inmediata y a largo plazo. Diagnósticos (NANDA): Son la definición de los problemas detectados, desde el punto de vista de la patología serían problemas interdisciplinares (se afrontarían por el equipo multidisciplinar), u orientados a las respuestas humanas, problemas independientes (afrontados por el equipo de enfermería). Resultados esperados.- Son los objetivos que la enfermera pretende alcanzar. Vienen relacionados con el problema detectado y en cada caso se eligen los más adecuados según el criterio de la enfermera. Siguen la clasificación NOC Clasificación CRE (Clasificación de los Resultados de Enfermería). Intervenciones de enfermeria.- Están descritas en la clasificación NIC (Nursing Interventions Classification) Clasificación de Intervenciones de Enfermería (CIE) y precisan de una valoración continua de las mismas.

ABSTRACT Introduction.- Neonatal abstinence syndrome (NAS) is a term used to denote a group of problems facing the newborn when he or she is no longer exposed to substances, drugs or narcotics. The dramatic increase in drug addiction in our population at the present time does not exclude women at the age of conception. A high number of women consume legal or illegal drugs during pregnancy and this is the cause of a public health problem that has great clinical, social and psychological repercussions for the newborn. It is estimated that one out of every 10 newborns may have been exposed to drugs during the intrauterine period. The abused drugs that the pregnant woman might consume are very varied as are its effects on the fetus and the neonate. NAS is going to become much more frequent (55-94% who are exposed to opiates or heroine). In this study we will concentrate on the NAS produced by opiate abstinence, given that more than 66% of children of women who depend on this type of drug show signs of NAS. The syndrome start date varied from shortly after birth, until two weeks of age. The signs appear about 72 hours after birth in most cases. The symptoms last from 8 to 16 weeks or more. Objectives.- Given its importance it is hoped that a standardized protocol might be established which could serve as a guide to nurses who work in Neonatology Units. Methodology (materials and methods).- A documented study has been carried out about NAS and the nursing process has been used as the instrument for executing protocol. The diagnostic protocol use nomenclature according to the (NANDA) North American Nursing Diagnosis Association. The nursing interventions are according to the NIC system (Nursing Interventions Classification) and the evaluation of results according to the NOC system (Nursing Outcomes Classification). The NOC system attempts to control the results after the various interventions in an immediate way and in the long term. Conclusions.- It is vitally important to use methodological instruments such as the nursing process (which should include diagnosis, interventions and results) for the elaboration and setting up of care protocols and for guaranteeing the quality and continuity of these protocols. Health education and the interaction between the nursing team and parents is very relevant in order to avoid possible hospital re-admittance and to achieve good quality care after hospital discharge.