A importância do acolhimento com classificação de risco nos serviços de emergência

RESUMO O Acolhimento com Classificacao de Risco e uma importante ferramenta desenvolvida para promover melhorias na organizacao dos servicos de emergencia, onde os atendimentos sao realizados conforme o grau de gravidade apresentado pelo paciente, por riscos de agravamento ou ainda pelo grau de vulnerabilidade dos mesmos. O principal proposito e promover um atendimento mais qualificado, organizado e humanizado, definindo prioridades de acordo com o grau de complexidade apresentado pelos usuarios dos servicos de emergencia e nao pelo antigo  sistema,  no  qual  os  pacientes  eram  atendidos  por  ordem  de  chegada, podendo acarretar riscos e agravos a saude deles. O presente estudo teve como objetivo identificar na literatura os beneficios da pratica do acolhimento com classificacao de risco e demonstrar a relevância do mesmo para os usuarios que buscam esses servicos.  A pesquisa foi qualitativa  e  realizada atraves  de  uma revisao da literatura dos ultimos dez anos, com artigos publicados nas Bases de Dados de Enfermagem (BDEnf), da Literatura Latino-americana e do Caribe em Ciencias da Saude (LILACS), Scientific Eletronic Librari Online (SCIELO) e por publicacoes do Ministerio da Saude. Foram analisados 16 artigos cientificos, 01 tese de mestrado e 01 de pos- graduacao e 03 cartilhas do Ministerio da Saude, no periodo de janeiro de 2002 a marco de 2012, totalizando 21 itens. O trabalho visou identificar por meio da producao cientifica de que forma vem sucedendo a pratica do acolhimento nos servicos de urgencia e emergencia. Surgiram no estudo tres categorias: relativas a Implantacao do Acolhimento com Avaliacao e Classificacao de Risco, a Superlotacao dos servicos de emergencia e a Humanizacao no Acolhimento. Verificam-se como aspectos significativos a atuacao conferida a profissionais de saude, com destaque ao enfermeiro ; a organizacao dos servicos de emergencia por grau de gravidade e nao por ordem de chegada e da valorizacao dos usuarios, por meio da escuta qualificada, buscando classificar os atendimentos de forma mais humanizada.  A utilizacao dessa proposta nos servicos de emergencia demonstra grande relevância, contudo ainda sao muitos os desafios para promover uma assistencia de acordo com os ideais das politicas de saude do SUS. Pala v ras-chave:  Acolhimento. Classificacao de Risco. Enfermagem de Emergencia. ABSTRACT  The welcoming with risk classification is an importance tool developed to promote the betterment of organization in emergency services. The attendances are performed according to the degree of severity presented by the patient, by aggravation risks or even by the patients’ degree of vulnerability. The main purpose is to promote a more qualified, organized and humanized attendance by defining priorities according to the degree of complexity presented by the emergency services users, and not by the previous system in which patients were seen in the order of their arrival. The previous system could entail risks and hazards to the patients’ health. The goal of this study was to identify in literature the benefits of the welcoming with risk classification in emergency services practice and demonstrate its relevance to services users. The research was qualitative and carried out through a literature review of the past ten years with articles published in Nursing Databases(BDENF)  from Latin American Literature and Caribbean Health Sciences (LILACS), Scientific Eletronic Librari Online (SCIELO) and by publications of the Ministry of Health. 16 scientific articles, 01 master's degree thesis, 01 graduate monograph and 03 booklets developed by the Ministry of Health were analyzed within the period from January 2002 to March 2012, totaling 21 items. This work aimed to identify by means of scientific production how the welcoming with risk classification in emergency and urgency services practice has occurred. During research, three categories arose:  the first, related to the welcoming with risk classification implementation; the second, related to the overcrowding in emergency services and the third, related to the humanized welcoming. It is verifiable information certain meaningful aspects about the attributed performance to the health care professionals, especially those in the nursing area; the emergency services organized according to the degree of severity and not by order of arrival and the appreciation of users by means of a qualified listening aiming  to classify attendances in a more humanized way. The use of this proposal in emergency services demonstrates great relevance. However, there are still many challenges in promoting a service in accordance with the ideals of SUS health policies. Key words: Welcoming. Risk classification. Emergency nursing.