Protocolo institucional padrão como tecnologia em saúde para o uso do brinquedo terapêutico no cuidado a criança submetida à punção venosa periférica

Abstract

Introduction: Hospitalization is an experience that drastically changes children's daily lives. During this experience, routine interventions are performed, with peripheral venipuncture being one of them. This intervention is carried out through the insertion of a needled catheter in a number appropriate to age and body mass. Because it is invasive, the child has difficulty understanding the treatment necessary for their recovery. To support healthcare professionals, during peripheral venipuncture, a therapeutic toy can be used. This is a health education tool that can be mediated by objects that become therapeutic. For its effective application, it is necessary to use the protocol associated with the use of therapeutic toys, which will contribute to patient safety, standardizing care practices, promoting the humanization of care and valuing interventions during the hospitalization process. Objectives: Improve existing standard institutional protocol to support nursing care for children undergoing peripheral venipuncture; and its specific objectives are: to map national and international studies on assistance to children with peripheral venipuncture; update care protocol in nursing care for children with peripheral venipuncture; evaluate the care protocol in nursing care for children with peripheral venipuncture; validate the content and appearance of the protocol based on contributions from healthcare professionals; propose recommendations for implementing the protocol, in health services, with a view to qualifying assistance and humanizing pediatric care; highlight the importance of continuous training of health professionals to implement humanizing strategies in the care of hospitalized children. Method: This is Methodological Research that aims to investigate methods for collecting and organizing data for the application of the Standard Institutional Protocol, which favors the conduct of investigations with greater rigor. Developed in four phases: literature review; adjustment to the protocol drawn up in 2021, validation of the content and appearance of the protocol; and evaluation with target audience. The project was submitted and approved to the Research Ethics Committee of the State Department of Health of the Federal District – CEP – SES/DF through final opinion 5.192.420 and CAAE 53246921.4.0000.5553. Results: The developed and validated protocol may contribute to improving the quality of care provided to hospitalized children using peripheral venipuncture, promoting patient safety and health updates for nursing professionals. Developed products: Product 1: Review manuscript entitled “Therapeutic toy in supporting nurses during peripheral venous puncture in children.” The review showed positive results regarding the professionals' willingness to use the therapeutic toy, as well as proposing a model for implementing the use of therapeutic toys in pediatric units, especially in the intensive care unit. Product 2: Process of developing the therapeutic toy to support nursing care for children undergoing peripheral venous puncture. The therapeutic toy is considered a low-cost simulator, and therefore this simulator was produced and is made of 100% polyester silicone fiber (stuffing foam) and nonwoven fabric; it is fully disinfectable with 70% alcohol, with disinfection recommended after each use. Product 3: Developed protocol called “Standard Institutional Protocol for Preparing the Child Undergoing Peripheral Venous Puncture Through Therapeutic Play”. The protocol content was outlined with the help of institutional manuals: ebook “Therapeutic Play in Nursing Care for Children,” published by the Brazilian Society of Pediatric Nurses; Technical Note No. 4/2022 from Anvisa, on safe practices for preventing incidents involving peripheral intravenous catheters in healthcare services; Resolution No. 546/2017 from the Federal Nursing Council, and Ordinance 529/2013 from the Ministry of Health on the Patient Safety Policy. Thus, Version-1 was adjusted after content and appearance validations, resulting in Versions 2 and 3. After completing the phases, the protocol, Version-4, is concluded, presented through o link: https://docs.google.com/document/d/1gTrFEPLDTcIR0fQSjW1SuqCJMkemH8YN/edit?usp=sharing&ouid=103496046691393723283&rtpof=true&sd=true. Este protocolo foi registrado na Câmara Brasileira do Livro sob o ID de Copyright DA-2025-10399, em 7 de novembro de 2025. Product 4: Manuscript submitted to the Brazilian Journal of Nursing entitled 'Study on the Validation of an Institutional Protocol for Venipuncture in Children Mediated by Therapeutic Toys,' aiming to propose a standard institutional protocol to support nursing care for children undergoing peripheral venipuncture, developed through a methodological study carried out in three phases: phase 1, adjustments to the previously prepared protocol; phase 2, content validation, in which seven judges participated, obtaining an index of 0.86; phase 3, face validation, with the participation of nine nurses, index 0.98. Therefore, the protocol was considered relevant, concluding that the validated protocol can guide, organize, and facilitate care planning, with the aim of promoting quality in the care provided to hospitalized children. Product 5: Refers to the Technical Report presented to the Permanent Protocol Committee of the State Health Department of the Federal District with the proposal of recommendations for the implementation of the protocol in health services, aiming at improving care quality and humanizing pediatric care, and highlighting the importance of continuous training of health professionals for the implementation of this humanizing strategy. Submitted in SEI 00060-00111928/2026-42.Conclusions: The use of instructional therapeutic toys stands out as an innovative strategy that qualifies assistance, promotes patient safety, contributing to minimizing the emotional impacts of child hospitalization. Associating the therapeutic toy tool with the elaborated and validated protocol highlights an advance in pediatric care, and reinforces that the use of the instructional therapeutic toy, with the use of the doll as a mediator, may not just be a common toy in the hospital environment, but an essential therapeutic tool that can humanize care and minimize the trauma of hospitalization for children, in line with professional practice and the guidelines of the Federal Nursing Council and the National Patient Safety Policy. Furthermore, the findings provide solid evidence to support discussions and improve public health policies focused on the well-being of hospitalized children, promoting the integration of the standard institutional protocol with instructional therapeutic toys as an essential part of pediatric care.