Diagnósticos de enfermagem em idosos com COVID-19 em uso de ventilação mecânica invasiva: um estudo longitudinal

Objective: To identify the NANDA International Nursing Diagnoses (ND) in older adults in intensive care for COVID-19 who required invasive mechanical ventilation support. Methods: A longitudinal observational study, based on the retrospective analysis of nursing records from 41 patient charts at three distinct moments: upon admission to the intensive care unit, 24 hours after orotracheal intubation, and at the moment before the outcome (discharge, death, or extubation). Odds ratios were calculated. The manuscript was guided by the STROBE statement. Results: With an average hospitalization time of 17 days, 127 NDs were identified at admission, 133 NDs 24 hours after intubation, and 159 NDs before the outcome. "Risk for Infection" had the highest frequency throughout hospitalization (53.7%, 75.6%, and 87.8%), while the diagnosis of "Anxiety" showed the largest negative variation (-240%). While "Anxiety" increased the odds of "Ineffective Airway Clearance" (7.5 times) and "Ineffective Breathing Pattern" (27.7 times), "Ineffective Breathing Pattern”, in turn, was associated with "Risk for Impaired Skin Integrity" (59 times). Conclusions: Different NDs were identified throughout the hospitalization of the older adults, with great variability in frequencies, depending on the clinical moment evaluated.