FATORES FACILITADORES E DIFICULTADORES PARA PREVENÇÃO DE LESÃO POR PRESSÃO PELA ENFERMAGEM EM UNIDADE DE TERAPIA INTENSIVA ADULTO: CONSTRUÇÃO E VALIDAÇÃO DE INSTRUMENTO

Abstract

Pressure injury (PI) is an adverse event with a significant impact on hospital care, especially in intensive care units (ICUs), where incidence rates can reach up to 62.5%. PI is associated with increased morbidity and mortality, prolonged hospitalization, higher costs, and increased workload for the nursing team. Prevention is essential but faces challenges, including facilitating and hindering factors, which still lack systematic investigation and validated instruments for their identification and management. Given this scenario, this study aimed to develop and validate an instrument to identify facilitators and barriers to PI prevention by nursing professionals in adult ICUs. This is a methodological study with a quantitative approach, developed in three stages: (1) integrative literature review, which enabled the identification of relevant variables for the instrument's construction; (2) content validation by experts, using the Delphi Technique to ensure item representativeness; and (3) pre-testing with ICU nurses, to assess the clarity and applicability of the instrument in clinical practice. The final validated instrument consists of 20 items, divided into two main domains: facilitators (10 items) and barriers (10 items). Among the key facilitators identified are staff training, the use of the Braden Scale, adherence to care protocols, and the availability of technological resources. On the other hand, barriers include work overload, lack of necessary supplies, patients' clinical complexity, and low team adherence to PI prevention measures. The Content Validity Index (CVI) was used to analyze the instrument's items, with a minimum satisfactory score of 0.80. The validation process resulted in the reformulation of 11 items and the exclusion of one item during pre-testing, ensuring that the final instrument presented clarity, relevance, and practical applicability. The validated instrument serves as a strategic tool for nursing management, allowing a situational diagnosis of the conditions that facilitate or hinder PI prevention. Its periodic application enables the identification of critical points within the sector and the team, supporting decision-making and the implementation of evidence-based improvements. Furthermore, it contributes to aligning nursing care practices with patient safety protocols and the Sustainable Development Goals (SDGs), particularly SDG 3 – Good Health and Well-being. As a recommendation for future studies, it is suggested that the instrument be tested in other hospital units beyond ICUs, as well as its effectiveness in reducing PI incidence. The validation of this instrument represents a significant advancement in nursing, strengthening patient safety and improving the quality of care provided.