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Um percurso de desenvolvimento de competências de enfermeiro especialista
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| 2.86 MB | Adobe PDF |
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Abstract(s)
A Enfermagem Médico-Cirúrgica no cuidado à Pessoa em Situação Crítica constitui uma área de intervenção complexa e exigente, que requer competências especializadas, sustentadas por conhecimento científico avançado, raciocínio clínico apurado e capacidade de resposta rápida e eficaz. A prática baseada na evidência científica implica a utilização rigorosa dos melhores resultados da investigação para fundamentar decisões clínicas seguras e eficazes. A reflexão crítica promove a análise contínua das intervenções, identificando oportunidades de melhoria e adaptando-as ao contexto clínico. Durante o estágio, este processo realizou-se através da análise crítica de casos complexos, discussões multidisciplinares e otimização de práticas, como na gestão de dispositivos avançados e na comunicação na transição de cuidados de enfermagem. Esta integração entre evidência e reflexão contribuiu para a qualidade dos cuidados e fortaleceu competências essenciais ao desempenho autónomo do enfermeiro especialista. Este relatório documenta o percurso de aquisição e desenvolvimento de competências no âmbito do estágio final do Curso de Mestrado em Enfermagem Médico-Cirúrgica à Pessoa em Situação Crítica. A experiência clínica, realizada numa Unidade de Cuidados Intensivos de Cirurgia Cardiotorácica e num Serviço de Urgência, permitiu consolidar conhecimentos teóricos e práticos A prestação de cuidados à pessoa em situação crítica revelou-se um desafio exigente, onde a tomada de decisão rápida e fundamentada, a colaboração multidisciplinar e a humanização dos cuidados assumiram um papel central. O estágio permitiu cumprir os objetivos definidos, abrangendo a prestação de cuidados especializados, a resposta em situações de emergência, a prevenção e controlo de infeção e a gestão dos cuidados de enfermagem. Foram superados desafios como a adaptação a diferentes contextos clínicos, a gestão de dispositivos avançados de monitorização e suporte, bem como a relação terapêutica com a família do doente em momentos de elevada carga emocional. A experiência adquirida foi fundamental para a consolidação de competências do enfermeiro especialista em enfermagem médico-cirúrgica, contribuindo para um desempenho profissional mais seguro e fundamentado. Durante o estágio foram desenvolvidas atividades focadas na prestação de cuidados especializados à pessoa em situação crítica, destacando-se a realização de avaliações clínicas detalhadas, a implementação de intervenções terapêuticas diferenciadas, a identificação precoce de gravidade e deterioração clínica. Destacou-se ainda o acompanhamento próximo de situações clínicas emergentes e a colaboração ativa em equipas multidisciplinares, contribuindo para uma abordagem mais eficaz e integrada dos cuidados prestados. Foi realizada uma revisão integrativa da literatura sobre a comunicação na transição de cuidados de enfermagem, com o objetivo de identificar estratégias que promovem a segurança do doente em contextos críticos. Os resultados desta investigação foram disseminados através da participação no VIII Fórum das Especialidades, sob a forma de um póster científico, o que permitiu não apenas a partilha de conhecimento atualizado com outros profissionais, mas também a reflexão crítica sobre a prática atual. A elaboração deste relatório permitiu uma reflexão crítica sobre o percurso realizado, reforçando a importância da formação contínua, da investigação e da melhoria da qualidade dos cuidados prestados.
Medical-Surgical Nursing in the Care of the Critically Ill Person is a complex and demanding area of intervention that requires specialised skills, supported by advanced scientific knowledge, refined clinical reasoning, and the ability to respond quickly and effectively. Evidence-based practice involves the rigorous use of the best available research findings to support safe and effective clinical decisions. Critical reflection fosters the continuous analysis of interventions, identifying opportunities for improvement and adapting them to the clinical context. During the internship, this process was carried out through the critical analysis of complex cases, multidisciplinary discussions, and the optimisation of practices, such as the management of advanced devices and communication during nursing care transitions. This integration of evidence and reflection contributed to the quality of care and strengthened key competencies essential to the autonomous role of the specialist nurse. This report documents the process of acquiring and developing competencies during the final internship of the Master's Degree in Medical-Surgical Nursing in Critical Care. The clinical experience, undertaken in a Cardiothoracic Surgery Intensive Care Unit and in an Emergency Department, allowed for the consolidation of both theoretical and practical knowledge. Providing care to critically ill individuals proved to be a demanding challenge, where swift and well-founded decision-making, multidisciplinary collaboration, and the humanisation of care played a central role. The internship enabled the achievement of the defined objectives, including the delivery of specialised care, response in emergency situations, infection prevention and control, and nursing care management. Challenges were overcome, such as adapting to different clinical settings, managing advanced monitoring and support devices, and establishing a therapeutic relationship with the patient's family during emotionally intense moments. The experience gained was fundamental to consolidating the competencies of the specialist nurse in medical-surgical nursing, contributing to a safer and more evidence-based professional practice. Activities carried out during the internship focused on the delivery of specialised care to critically ill individuals, highlighting detailed clinical assessments, the implementation of differentiated therapeutic interventions, and the early identification of clinical deterioration. Close monitoring of emergent clinical situations and active collaboration in multidisciplinary teams also stood out, contributing to a more effective and integrated approach to care. An integrative literature review was conducted on communication during the transition of nursing care, aiming to identify strategies that promote patient safety in critical contexts. The results of this research were disseminated at the 7th Forum of Specialties in the form of a scientific poster, which enabled not only the sharing of up-to-date knowledge with other professionals but also critical reflection on current practice. The drafting of this report allowed for a reflective overview of the journey undertaken, reinforcing the importance of continuous training, research, and the improvement of the quality of care provided.
Medical-Surgical Nursing in the Care of the Critically Ill Person is a complex and demanding area of intervention that requires specialised skills, supported by advanced scientific knowledge, refined clinical reasoning, and the ability to respond quickly and effectively. Evidence-based practice involves the rigorous use of the best available research findings to support safe and effective clinical decisions. Critical reflection fosters the continuous analysis of interventions, identifying opportunities for improvement and adapting them to the clinical context. During the internship, this process was carried out through the critical analysis of complex cases, multidisciplinary discussions, and the optimisation of practices, such as the management of advanced devices and communication during nursing care transitions. This integration of evidence and reflection contributed to the quality of care and strengthened key competencies essential to the autonomous role of the specialist nurse. This report documents the process of acquiring and developing competencies during the final internship of the Master's Degree in Medical-Surgical Nursing in Critical Care. The clinical experience, undertaken in a Cardiothoracic Surgery Intensive Care Unit and in an Emergency Department, allowed for the consolidation of both theoretical and practical knowledge. Providing care to critically ill individuals proved to be a demanding challenge, where swift and well-founded decision-making, multidisciplinary collaboration, and the humanisation of care played a central role. The internship enabled the achievement of the defined objectives, including the delivery of specialised care, response in emergency situations, infection prevention and control, and nursing care management. Challenges were overcome, such as adapting to different clinical settings, managing advanced monitoring and support devices, and establishing a therapeutic relationship with the patient's family during emotionally intense moments. The experience gained was fundamental to consolidating the competencies of the specialist nurse in medical-surgical nursing, contributing to a safer and more evidence-based professional practice. Activities carried out during the internship focused on the delivery of specialised care to critically ill individuals, highlighting detailed clinical assessments, the implementation of differentiated therapeutic interventions, and the early identification of clinical deterioration. Close monitoring of emergent clinical situations and active collaboration in multidisciplinary teams also stood out, contributing to a more effective and integrated approach to care. An integrative literature review was conducted on communication during the transition of nursing care, aiming to identify strategies that promote patient safety in critical contexts. The results of this research were disseminated at the 7th Forum of Specialties in the form of a scientific poster, which enabled not only the sharing of up-to-date knowledge with other professionals but also critical reflection on current practice. The drafting of this report allowed for a reflective overview of the journey undertaken, reinforcing the importance of continuous training, research, and the improvement of the quality of care provided.
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Enfermagem médico cirúrgica Pessoa em situação crítica Competência profissional Comunicação Medical-surgical nursing Critically ill patient Professional skills Communication
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