| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 2.48 MB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
A elaboração deste trabalho desenvolve-se no âmbito da Unidade Curricular – Estágio Final e Relatório – do 1º semestre do 2º ano, do 16º Curso de Mestrado em Enfermagem com especialização em enfermagem médico-cirúrgica na área de enfermagem à Pessoa em Situação Crítica, da Escola de Enfermagem (Porto), da Universidade Católica Portuguesa, no ano letivo 2023/2024. Surge no âmbito da realização de estágio, primeiramente, em contexto de Unidade de Cuidados Intensivos Cardiotorácica, seguida em contexto de Serviço de Medicina Intensiva Polivalente, tendo como ponto de partida as competências desenvolvidas no estágio do 1º ano do Curso, realizado no Serviço de Urgência Polivalente. Este relatório abrange uma contextualização dos locais de estágio, bem como, a ilustração e reflexão do percurso realizado durante o estágio em ambos os contextos, demonstrando uma reflexão crítica e fundamentada, sobre as ações observadas e realizadas em resposta aos objetivos traçados em projeto individual, espelhando a aquisição das competências alcançadas. Na área da melhoria contínua da qualidade, no contexto de Unidade de Cuidados Intensivos Cardiotorácica, desenvolveu-se um estudo de caso, explorando as intervenções de enfermagem prioritárias ao momento de admissão do doente, com vista à sistematização da assistência de enfermagem principalmente no que se refere à formulação de diagnósticos voltados ao cuidado pós-operatório do doente submetido a cirurgia cardíaca. No contexto do Serviço de Medicina Intensiva Polivalente, no sentido de uniformizar a atuação da prática em enfermagem nos cuidados prestados ao doente com a presença de colar cervical, foi elaborado um trabalho sob a estrutura de uma proposta de protocolo para o serviço, essencialmente através de uma fundamentação teórica baseada na evidência científica sobre o tema e elencadas intervenções de enfermagem para o apoio na prática clínica. Dado o facto de a presença de colar cervical ser uma área tão específica, e poder ter restringido e limitado à pesquisa bibliográfica elaborada anteriormente, surge a necessidade de pesquisar de uma forma mais abrangente o tema relacionado com as Medical Device Related Pressure Injury, através de uma revisão da literatura, onde emergiram várias medidas preventivas. Com o objetivo de identificar as necessidades da pessoa, família e cuidadores, assegurando a deteção precoce, estabilização, manutenção e a recuperação, em doentes da área de cuidados intensivos e atingir os objetivos definidos no projeto individual de estágio, foram desenvolvidas diversas atividades. Assim afirma-se que os contextos proporcionaram a vivência de inúmeras oportunidades de aprendizagem, tais como a execução de cuidados técnicos de alta complexidade dirigidos à pessoa a vivenciar processos de doença crítica e/ou falência orgânica, a identificação atempada de sinais de deterioração do estado clínico da pessoa em situação crítica, respondendo de forma efetiva em situações inesperadas e o desenvolvimento da capacidade de raciocínio clínico, de atuação e de tomada de decisão em situações de instabilidade hemodinâmica. Dessa forma, pode-se inferir que este percurso de aprendizagem teve implicações na prática profissional, como o desenvolvimento da capacidade de reflexão e avaliação crítica na abordagem holística do doente e na prestação de cuidados baseados na melhor evidência científica, contribuindo, com a realização dos trabalhos científicos, para a investigação e desenvolvimento da profissão.
This work was written as part of the Final Internship and Report course of the 1st semester of the 2nd year of the 16th Master's Degree in Nursing, specialising in medical-surgical nursing in the area of nursing for people in critical situations, at the School of Nursing (Porto) of the Universidade Católica Portuguesa, in the 2023/2024 academic year. It comes about as part of the internship, firstly in the context of the Cardiothoracic Intensive Care Unit, then in the context of the Multipurpose Intensive Care Medicine Service, taking as a starting point the competences developed in the 1st year of the course, carried out in the Multipurpose Emergency Service. This report includes a contextualisation of the internship sites, as well as an illustration and reflection of the path taken during the internship in both contexts, demonstrating a critical and reasoned reflection on the actions observed and carried out in response to the objectives set out in the individual project, reflecting the acquisition of the competences achieved. In the area of continuous quality improvement, in the context of the Cardiothoracic Intensive Care Unit, a case study was developed, exploring the priority nursing interventions at the time of patient admission, with a view to systematising nursing care, especially with regard to the formulation of diagnoses for the post-operative care of patients undergoing cardiac surgery. In the context of the Multipurpose Intensive Care Medicine Service, in order to standardise nursing practice in the care of patients with cervical collars, a study was drawn up in the form of a proposed protocol for the service, essentially through a theoretical foundation based on scientific evidence on the subject and listed nursing interventions to support clinical practice. Given that the presence of a cervical collar is such a specific area, and could have restricted and limited the bibliographical research carried out previously, the need arose to research the topic of Medical Device Related Pressure Injury in a more comprehensive way, through a literature review, where various preventative measures emerged. With the aim of identifying the needs of the person, family and carers, ensuring early detection, stabilisation, maintenance and recovery in intensive care patients and achieving the objectives defined in the individual internship project, various activities were carried out. It can therefore be said that the contexts provided numerous learning opportunities, such as performing highly complex technical care for people experiencing critical illness and/or organ failure, identifying signs of deterioration in the clinical state of people in critical situations in good time, responding effectively in unexpected situations and developing clinical reasoning, acting and decision-making skills in situations of haemodynamic instability. It can therefore be inferred that this learning process has had implications for professional practice, such as the development of the capacity for reflection and critical evaluation in the holistic approach to the patient and the provision of care based on the best scientific evidence, contributing to research and the development of the profession by carrying out scientific work.
This work was written as part of the Final Internship and Report course of the 1st semester of the 2nd year of the 16th Master's Degree in Nursing, specialising in medical-surgical nursing in the area of nursing for people in critical situations, at the School of Nursing (Porto) of the Universidade Católica Portuguesa, in the 2023/2024 academic year. It comes about as part of the internship, firstly in the context of the Cardiothoracic Intensive Care Unit, then in the context of the Multipurpose Intensive Care Medicine Service, taking as a starting point the competences developed in the 1st year of the course, carried out in the Multipurpose Emergency Service. This report includes a contextualisation of the internship sites, as well as an illustration and reflection of the path taken during the internship in both contexts, demonstrating a critical and reasoned reflection on the actions observed and carried out in response to the objectives set out in the individual project, reflecting the acquisition of the competences achieved. In the area of continuous quality improvement, in the context of the Cardiothoracic Intensive Care Unit, a case study was developed, exploring the priority nursing interventions at the time of patient admission, with a view to systematising nursing care, especially with regard to the formulation of diagnoses for the post-operative care of patients undergoing cardiac surgery. In the context of the Multipurpose Intensive Care Medicine Service, in order to standardise nursing practice in the care of patients with cervical collars, a study was drawn up in the form of a proposed protocol for the service, essentially through a theoretical foundation based on scientific evidence on the subject and listed nursing interventions to support clinical practice. Given that the presence of a cervical collar is such a specific area, and could have restricted and limited the bibliographical research carried out previously, the need arose to research the topic of Medical Device Related Pressure Injury in a more comprehensive way, through a literature review, where various preventative measures emerged. With the aim of identifying the needs of the person, family and carers, ensuring early detection, stabilisation, maintenance and recovery in intensive care patients and achieving the objectives defined in the individual internship project, various activities were carried out. It can therefore be said that the contexts provided numerous learning opportunities, such as performing highly complex technical care for people experiencing critical illness and/or organ failure, identifying signs of deterioration in the clinical state of people in critical situations in good time, responding effectively in unexpected situations and developing clinical reasoning, acting and decision-making skills in situations of haemodynamic instability. It can therefore be inferred that this learning process has had implications for professional practice, such as the development of the capacity for reflection and critical evaluation in the holistic approach to the patient and the provision of care based on the best scientific evidence, contributing to research and the development of the profession by carrying out scientific work.
Description
Keywords
Enfermeiro especialista Pessoa em situação crítica Competências Diagnóstico de enfermagem Úlcera por pressão Dispositivo médico Nurse specialist Person in a critical situation Competences Nursing diagnosis Pressure ulcer Medical device