Keywords
Intensive Care Units
Multiple Trauma
Critical Care Nursing
Patient-Centered Care
How to Cite
Abstract
Objective: to critically analyze contemporary evidence on the humanization of nursing care for polytraumatized patients in intensive care units, emphasizing clinical reasoning, safety, and quality management. Method: an integrative review guided by Whittemore and Knafl and by Mendes, Silveira, and Galvão, with searches in PubMed/MEDLINE, LILACS, SciELO, and the Virtual Health Library for studies published from 2021 to August 29, 2026. The review question was structured using the PICo strategy, and study selection was reported according to PRISMA 2020. Results: thirty-two studies were included and organized into four categories: person- and family-centered care; pain, sedation, delirium, sleep, and mobilization; polytrauma and neurotrauma; and management and quality indicators. Conclusion: humanizing critical polytrauma care is a clinical and managerial safety strategy that depends on nursing competencies, evidence-based protocols, adequate staffing, and systematic outcome monitoring.
References
AMERICAN HEART ASSOCIATION. 2025 American Heart Association Guidelines for CPR and Emergency Cardiovascular Care. Dallas: AHA, 2025. Disponível em: https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines. Acesso em: 29 ago. 2026.
ANDRADE, Débora de Fátima Sousa et al. Nursing interventions to prevent posttraumatic stress disorders in people in intensive care: a scoping review. Dimensions of Critical Care Nursing, v. 44, n. 1, p. 36-43, 2025. DOI: 10.1097/DCC.0000000000000677.
AROMATARIS, Edoardo; LOCKWOOD, Craig; PORRITT, Kylie; PILLA, Balaji; JORDAN, Zoe (ed.). JBI Manual for Evidence Synthesis. Adelaide: JBI, 2024. DOI: 10.46658/JBIMES-24-01. Disponível em: https://synthesismanual.jbi.global. Acesso em: 30 ago. 2026.
BARR, Juliana et al. Improving outcomes in mechanically ventilated adult ICU patients following implementation of the ICU Liberation (ABCDEF) Bundle across a large healthcare system. Critical Care Explorations, v. 6, n. 1, e1001, 2024. DOI: 10.1097/CCE.0000000000001001.
BARRETO DE SOUZA, Jennifer Menna et al. Long-term effects of flexible visitation in the intensive care unit on family members' mental health: 12-month results from a randomized clinical trial. Intensive Care Medicine, v. 50, n. 10, p. 1614-1621, 2024. DOI: 10.1007/s00134-024-07577-3.
BRASIL. Ministério da Saúde. Política Nacional de Humanização: PNH. Brasília, DF: Ministério da Saúde, 2013.
CEZAR, Augusto Garcia de; DEL CASTANHEL, Flávia; GROSSEMAN, Suely. Necessidades de familiares de pacientes em terapia intensiva e sua percepção da comunicação médica. Critical Care Science, v. 35, n. 1, p. 73-83, 2023. DOI: 10.5935/2965-2774.20230374-pt.
CORREYA, Anu et al. Nurses' perceptions of patient pain, delirium, and sedation assessments in the intensive care unit: a qualitative study. Australian Critical Care, v. 38, n. 1, 101076, 2025. DOI: 10.1016/j.aucc.2024.05.013.
CROSSFIELD, Claire; OZAVCI, Guncag; DIGBY, Robin; BUCKNALL, Tracey. A systematic review on the effect of telehealth communication with intensive care unit families on patient and family outcomes. Australian Critical Care, v. 38, n. 1, 101094, 2025. DOI: 10.1016/j.aucc.2024.06.013.
DAUM, Nils et al. Early mobilisation within 72 hours after admission of critically ill patients in the intensive care unit: a systematic review with network meta-analysis. Intensive & Critical Care Nursing, v. 80, 103573, 2024. DOI: 10.1016/j.iccn.2023.103573.
FERNANDES, Lillian Caroline et al. Predictive capacity of trauma indices for hospitalization and intensive care unit admission. Revista da Escola de Enfermagem da USP, v. 59, e20250092, 2025. DOI: 10.1590/1980-220X-REEUSP-2025-0092pt.
FERREIRA, Ráisa Camilo et al. Nursing interventions and activities for patients with multiple traumas: an integrative review. International Journal of Nursing Knowledge, v. 34, n. 4, p. 254-275, 2023. DOI: 10.1111/2047-3095.12401.
FERREIRA, Raisa Camilo et al. Using interoperable nursing care data to improve outcomes for multiple traumas patients with Impaired Physical Mobility. Journal of Clinical Nursing, v. 33, n. 7, p. 2562-2577, 2024. DOI: 10.1111/jocn.17140.
FIGUEIREDO, Rita; CASTRO, Cidália; FERNANDES, Júlio Belo. Nursing interventions to prevent secondary injury in critically ill patients with traumatic brain injury: a scoping review. Journal of Clinical Medicine, v. 13, n. 8, 2396, 2024. DOI: 10.3390/jcm13082396.
FRIBERG, Klara et al. Patient characteristics associated with posttraumatic stress symptoms in intensive care unit survivors during a one-year follow-up: a multicenter study. Heart & Lung, v. 66, p. 1-8, 2024. DOI: 10.1016/j.hrtlng.2024.02.011.
GORECKI, Nicole M.; PRASUN, Marilyn A. Intensive Care Unit Sleep Promotion Bundle: impact on sleep quality, delirium, and other patient outcomes. Critical Care Nurse, v. 44, n. 4, p. 11-18, 2024. DOI: 10.4037/ccn2024972.
GRAVANTE, Francesco et al. Quality of life in ICU survivors and their relatives with post-intensive care syndrome: a systematic review. Nursing in Critical Care, v. 29, n. 4, p. 807-823, 2024. DOI: 10.1111/nicc.13077.
GUNNLAUGSDÓTTIR, Thora et al. How can family members of patients in the intensive care unit be supported? A systematic review of qualitative reviews, meta-synthesis, and novel recommendations for nursing care. International Journal of Nursing Studies Advances, v. 7, 100251, 2024. DOI: 10.1016/j.ijnsa.2024.100251.
HICKEY, Johannah; WHITE, Mackenzie; GANTZ, Sarah. Best practices in the nursing care of patients with injuries from violence: an integrative review. Critical Care Nurse, v. 44, n. 5, p. 32-41, 2024. DOI: 10.4037/ccn2024639.
HÖGVALL, Lisa Maria et al. Creating a shared narrative: a qualitative study on the impact of nurse-written ICU diaries for TBI-survivors and their family caregivers. Neuropsychological Rehabilitation, p. 1-21, 2026. DOI: 10.1080/09602011.2026.2684576.
HWANG, David Y. et al. Society of Critical Care Medicine Guidelines on Family-Centered Care for Adult ICUs: 2024. Critical Care Medicine, v. 53, n. 2, p. e465-e482, 2025. DOI: 10.1097/CCM.0000000000006549.
LEE, Jungmin; KIM, Yeonju; LEE, Hyun Joo. Nurse-involved early mobilization in the intensive care unit: a systematic review and meta-analysis. Nursing in Critical Care, v. 30, n. 2, e13278, 2025. DOI: 10.1111/nicc.13278.
LEONG, Amanda Y. et al. The association between pain, analgesia, and delirium among critically ill adults: a systematic review and meta-analysis. Intensive Care Medicine, v. 51, n. 2, p. 342-352, 2025. DOI: 10.1007/s00134-025-07784-6.
LEWIS, Kimberley et al. A focused update to the clinical practice guidelines for the prevention and management of pain, anxiety, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Critical Care Medicine, v. 53, n. 3, p. e711-e727, 2025. DOI: 10.1097/CCM.0000000000006574.
LI, ZhiRu et al. Effectiveness of family-provider communication interventions on family's psychological health, communication quality, and health care utilization in the ICU: a systematic review and meta-analysis of randomized controlled trials. Intensive & Critical Care Nursing, v. 91, 104166, 2025. DOI: 10.1016/j.iccn.2025.104166.
MALTA, Deborah Carvalho et al. Mortality by road transport injury in Brazilian municipalities between 2000 and 2018. Public Health, v. 220, p. 120-126, 2023. DOI: 10.1016/j.puhe.2023.04.013.
MENDES, Karina Dal Sasso; SILVEIRA, Renata Cristina de Campos Pereira; GALVÃO, Cristina Maria. Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto & Contexto - Enfermagem, v. 17, n. 4, p. 758-764, 2008. DOI: 10.1590/S0104-07072008000400018.
MULIIRA, Joshua K. et al. The needs of families caring for patients with traumatic brain injury: a scoping review. Disability and Rehabilitation, v. 46, n. 20, p. 4586-4594, 2024. DOI: 10.1080/09638288.2023.2278178.
PAGE, Matthew J. et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, v. 372, n. 71, 2021. DOI: 10.1136/bmj.n71.
REIFARTH, Eyleen; BORREGA, Jorge Garcia; KOCHANEK, Matthias. How to communicate with family members of the critically ill in the intensive care unit: a scoping review. Intensive & Critical Care Nursing, v. 74, 103328, 2023. DOI: 10.1016/j.iccn.2022.103328.
SECUNDA, Katharine E.; KRUSER, Jacqueline M. Patient-centered and family-centered care in the intensive care unit. Clinics in Chest Medicine, v. 43, n. 3, p. 539-550, 2022. DOI: 10.1016/j.ccm.2022.05.008.
SILI, Eurico Mateus et al. Cuidado de enfermagem humanizado em terapia intensiva em Angola: facilidades e dificuldades desveladas. Texto & Contexto Enfermagem, v. 33, e20230111, 2024. DOI: 10.1590/1980-265X-TCE-2023-0111pt.
SILI, Eurico Mateus et al. Cuidado humanizado na Unidade de Terapia Intensiva: discurso dos profissionais de enfermagem angolanos. Revista Brasileira de Enfermagem, v. 76, n. 2, e20220474, 2023. DOI: 10.1590/0034-7167-2022-0474pt.
SOSNOWSKI, Kellie et al. The effect of the ABCDE/ABCDEF bundle on delirium, functional outcomes, and quality of life in critically ill patients: a systematic review and meta-analysis. International Journal of Nursing Studies, v. 138, 104410, 2023. DOI: 10.1016/j.ijnurstu.2022.104410.
SOUZA, Edinilsa Ramos de et al. Magnitude e evolução temporal das lesões e mortes no trânsito no Brasil, 2001 a 2021. Ciência & Saúde Coletiva, v. 30, n. 10, e15372025, 2025. DOI: 10.1590/1413-812320253010.15372025.
SUN, Xianghong et al. The meaning of respect and dignity for intensive care unit patients: a meta-synthesis of qualitative research. Nursing Ethics, v. 31, n. 4, p. 652-669, 2024. DOI: 10.1177/09697330231222598.
WANG, Lijie et al. The effects of early mobilization in mechanically ventilated adult ICU patients: systematic review and meta-analysis. Frontiers in Medicine, v. 10, 1202754, 2023. DOI: 10.3389/fmed.2023.1202754.
WHITTEMORE, Robin; KNAFL, Kathleen. The integrative review: updated methodology. Journal of Advanced Nursing, v. 52, n. 5, p. 546-553, 2005. DOI: 10.1111/j.1365-2648.2005.03621.x.
WORLD HEALTH ORGANIZATION. Emergency care toolkit. Geneva: WHO, 2025. Disponível em: https://www.who.int/tools/emergency-care-toolkit. Acesso em: 29 ago. 2026.
WORLD HEALTH ORGANIZATION. Global status report on road safety 2023: Brazil country profile. Geneva: WHO, 2024.
WORLD HEALTH ORGANIZATION. Road traffic injuries. Geneva: WHO, 20 jul. 2026. Disponível em: https://www.who.int/news-room/fact-sheets/detail/road-traffic-injuries. Acesso em: 29 ago. 2026.
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