Atuação do enfermeiro no processo regulatório de acesso: proposta de sistematização

Abstract

Introduction: Health systems have as principles universality, comprehensiveness and seek efficiency, with a view to quality and meeting the population's health needs. The nurse is inserted in this context as the protagonist of the regulatory process. Objective: Develop management technology that assists nurses in decision-making regarding the regulation of health services, based on the Systematization of Nursing Work. Method: This is a study on the development of assistance technology based on Applied Research studies. The study was organized into sequential phases, the first being the bibliographic review and the second, the elaboration of protocols and the development of the manual. The product was developed for use by the bed management unit, responsible for hospitalization procedures in clinical and surgical units for adults, in a large public hospital, located in the Central Region of the Federal District. The bibliographic review followed the scoping review manual from the Joanna Briggs Institute, in which the guiding question was formulated: what scientific evidence of Nurses' role in regulating access at different levels of care in Brazil? The second phase, elaboration of health technology, for the systematization of Nurses' work in health regulation, sought support in the review carried out and in the National Health Regulation Policy of the Unified Health System. The study began in August 2022 and finalized in July 2024. Results: The review was registered in the Open Science Framework, DOI 10.17605/OSF.IO/QCJ73. 18 studies were selected that relate health regulation to the work of nurses. Most studies related this professional to the managerial aspect of regulation, and little was observed about the Nurse being specified as a regulator. This review reinforced that the role of the Nurse is still little discussed in the literature, especially in Latin America, as a participating member of the team that promotes and carries out Health Regulation. Product elaborated: this research received financial support from Fomento CAPES/COFEN in the process SEI: 88887.689892/2022-00. 7 Standard Operating Procedures were developed and organized into a manual. The daily activities of this health center were organized, each in a Standard Operating Procedures: Patient transfer in Panorama 1, patient transfer in Panorama 2, patient transfer in Panorama 3, Procedure for admitting elective surgery patients, Procedure for the admission of emergency surgery patients, Procedure for the admission of patients discharged from the intensive care unit, Procedure for administrative and care routines in Bed Management. Conclusion: The Systematization of Nursing Work is an important means of ensuring quality care and nursing safety, in the field of Health Regulation, it supports the Nurse's actions in their work routine, reducing improvisations and helping with clinical reasoning critical, which is widely used by professionals when carrying out regulatory actions in their daily lives.