Learning Objective #1: Discuss the implantation process of nursing assistance methodology for people with severe multiple deficiencies

Learning Objective #2: Verify the importance of training human resources and the elaboration of an instrument for data collection adapted for people with severe multiple deficiencies

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In 2003, a project was begun with the objective of implanting nursing assistance methodology to the severely, multiply deficient in a philanthropic institution called “Cantinho do Céu – Lar dos Excepcionais. The aim of the institution is to offer social assistance to the severely multiply handicapped. It attends to 60 people between the ages of 2 and 43 years of age. The nursing team is made up of one registered nurse, two enrolled nurses and three nursing auxiliaries. As well as severe multiple deficiencies, there are clients that also have other difficulties such as pneumonia, pressure sores, gastrointestinal problems, tracheostomies and special medications, amongst other things. The first step was the theoretical and practical training of the registered nurse in the aspects of nursing assistance methodology. Following this, a specific instrument for the collection of data was drawn up and tested, based on Maslow's Basic Human Necessities. The next step constituted the application of the instrument and the analysis of the collected data, in which it was established initially two priority nurse diagnoses: the inefficient clearing of the nasal passages and prejudicial skin integrity. Afterwards, a revision of the literature was carried out in order to study the nurse interventions in regards to the established diagnoses. As a guideline, the Nurses Intervention Classification (NIC) was used and in accordance with the material and personnel resources of the institution, specific printed matter for documentation of the nursing assistance methodology steps taken, including the nursing intervention, was developed in the form of a checklist. The next step will include the identification of other diagnoses. This experience showed the importance of investing in training human resources and also the necessity for the elaboration of an instrument for data collection with specific adaptations for people with severe multiple deficiencies.