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Segurança da pessoa em situação crítica : vigilância clínica e prevenção de infeção
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O presente Relatório Final de Estágio foi elaborado no âmbito do Mestrado em Enfermagem com Especialização em Enfermagem Médico-Cirúrgica – Pessoa em Situação Crítica, da Escola de Enfermagem da Universidade Católica Portuguesa. O objetivo consiste em descrever e analisar, de forma crítico-reflexiva, o percurso formativo desenvolvido na unidade curricular Estágio com Relatório Final, visando a consolidação das competências necessárias ao exercício como enfermeiro especialista. O estágio integrou 360 horas de prática clínica em dois contextos complementares: um Serviço de Medicina Intensiva Polivalente e um Serviço de Controlo de Infeção e Resistência aos Antimicrobianos, em unidades hospitalares da região norte de Portugal. Estes contextos permitiram articular a prestação direta de cuidados à pessoa em situação crítica com uma abordagem organizacional e preventiva da segurança do doente. A metodologia adotada foi descritiva e crítico-reflexiva, sustentada na análise da prática clínica e na evidência científica. Em cuidados intensivos foram desenvolvidas competências na vigilância clínica avançada, avaliação neurológica, gestão da sedoanalgesia e tomada de decisão em situações de elevada complexidade. Foi ainda realizada uma revisão da literatura sobre instrumentos de avaliação do nível de consciência, analisando limitações da Escala de Coma de Glasgow e o contributo da Full Outline of UnResponsiveness. Os resultados sustentaram um webinar dirigido a enfermeiros de cuidados intensivos. No Serviço de Controlo de Infeção destacaram-se atividades de vigilância epidemiológica, auditoria clínica e a elaboração de uma proposta de Norma de Orientação Clínica para prevenção da infeção do local cirúrgico. Conclui-se que o percurso contribuiu para a consolidação das competências do enfermeiro especialista, reforçando o raciocínio clínico e o compromisso com a qualidade e segurança dos cuidados.
This Final Internship Report was prepared as part of the Master's Degree in Nursing with Specialisation in Medical-Surgical Nursing – Critical Care, at the School of Nursing of the Portuguese Catholic University. The objective is to describe and analyse, in a critical and reflective manner, the training course developed in the curricular unit Internship with Final Report, aiming at consolidating the skills necessary to practise as a specialist nurse. The internship included 360 hours of clinical practice in two complementary contexts: a Multipurpose Intensive Care Service and an Infection Control and Antimicrobial Resistance Service, in hospital units in northern Portugal. These contexts allowed for the direct provision of care to people in critical situations with an organisational and preventive approach to patient safety. The methodology adopted was descriptive and critical-reflective, based on the analysis of clinical practice and scientific evidence. In intensive care, skills were developed in advanced clinical surveillance, neurological assessment, sedoanalgesia management and decision-making in highly complex situations. A review of the literature on consciousness assessment tools was also conducted, analysing the limitations of the Glasgow Coma Scale and the contribution of the Full Outline of Unresponsiveness. The results supported a webinar aimed at intensive care nurses. The Infection Control Service highlighted epidemiological surveillance activities, clinical auditing, and the development of a proposal for Clinical Guidance Standards for the prevention of surgical site infections. It was concluded that the course contributed to the consolidation of the specialist nurse's skills, reinforcing clinical reasoning and commitment to the quality and safety of care.
This Final Internship Report was prepared as part of the Master's Degree in Nursing with Specialisation in Medical-Surgical Nursing – Critical Care, at the School of Nursing of the Portuguese Catholic University. The objective is to describe and analyse, in a critical and reflective manner, the training course developed in the curricular unit Internship with Final Report, aiming at consolidating the skills necessary to practise as a specialist nurse. The internship included 360 hours of clinical practice in two complementary contexts: a Multipurpose Intensive Care Service and an Infection Control and Antimicrobial Resistance Service, in hospital units in northern Portugal. These contexts allowed for the direct provision of care to people in critical situations with an organisational and preventive approach to patient safety. The methodology adopted was descriptive and critical-reflective, based on the analysis of clinical practice and scientific evidence. In intensive care, skills were developed in advanced clinical surveillance, neurological assessment, sedoanalgesia management and decision-making in highly complex situations. A review of the literature on consciousness assessment tools was also conducted, analysing the limitations of the Glasgow Coma Scale and the contribution of the Full Outline of Unresponsiveness. The results supported a webinar aimed at intensive care nurses. The Infection Control Service highlighted epidemiological surveillance activities, clinical auditing, and the development of a proposal for Clinical Guidance Standards for the prevention of surgical site infections. It was concluded that the course contributed to the consolidation of the specialist nurse's skills, reinforcing clinical reasoning and commitment to the quality and safety of care.
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Enfermeiro especialista Pessoa em situação crítica Avaliação do nível de consciência Cuidados intensivos Prevenção e controlo da infeção Specialist nurse Critically ill patient Assessment of level of consciousness Intensive care Infection prevention and control
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