Chronic Kidney Disease (CKD) is defined as abnormalities of kidney structure and / or function that are present for more than three months and have implications for the health of the individual and its main treatment is through renal replacement therapy (SRT) where hemodialysis (HD) is the most used mode today. Due to the large number of patients undergoing treatment, it is extremely important to perform Nursing care. The Systematization of Nursing Assistance (SAE) is a private instrument used by nurses to organize, plan, execute and evaluate the care that is being provided. The Nursing Process is a tool whose definition is to be a methodological tool that develops systematized actions that aim at quality assistance and individualized to the human being. Although the EP provides a guideline for the organization of holistic and humanized care with clear and defined goals, in addition to providing visibility of the role of the nurse. Some studies show that their use is still limited by these professionals, the difficulties are great and different factors act as a barrier to their full implementation. Thus, the present study will investigate: What challenges do nurses face in the implementation of PE in HD services? What progress has been made with the implementation of PE in these services? This is a qualitative cross-sectional descriptive study performed in two public hospitals and a hemodialysis clinic in Belém-PA with nurses from the HD service. The content analysis method was based on Bardin's explanations. This work is in compliance with Resolution 466/12 of the National Health Council. The research will benefit nurses in order to improve the application of the EP. In this way, the patient will benefit, as he will enjoy the quality of nursing care and safer. Fourteen nurses were interviewed, of which 11 were nurse assistants and three were Technical Responsible. According to the participants of this study, most nurses confuse the conceptual aspects of SAE and PE, another part poses as synonymous, even those who do not know the meaning and the concept. A small portion dominates and appropriates properly. It was also possible to identify that most nurses do not know about nursing theory, listing the references used for NANDA and carpenito nursing diagnoses. It was observed that the challenges faced are nurses' adherence, lack of time / shortage of human resources, and attention not to turn the EP into a check list. The results of the study did not show significant advances in the implementation of PE in HD services. The results of the study did not demonstrate significant advances in the implantation of PE in HD services. It is notable that many are the challenges for the implementation of PE, however, it is necessary for professionals to use this tool to provide quality and safe care to the patient.
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