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Deteção precoce de complicações no doente crítico
| Name: | Description: | Size: | Format: | |
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| 1.83 MB | Adobe PDF |
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Abstract(s)
O presente relatório pretende demonstrar o desenvolvimento de competências especializadas em enfermagem Médico Cirúrgica, na área do doente crítico, ao longo dos estágios. Durante o percurso de prática clínica, prestei cuidados especializados ao doente em estado crítico e à sua família em diferentes contextos. Procurei também desenvolver competências de formação em equipa, liderando ações de formação em serviço e contribuindo assim para a melhoria dos cuidados e segurança do doente através do desenvolvimento profissional dos enfermeiros. O estágio dividiu-se em três contextos: Serviço de Urgência, Unidade de Cuidados Pós-Anestésicos e Clínica de Hemodiálise. A escolha destes três campos de estágio deveu-se à necessidade de compreender melhor o percurso do doente crítico e aliar isso à minha experiência de trabalho de 2 anos numa enfermaria de medicina interna e, atualmente, numa Unidade de Cuidados Intensivos Polivalente, há cerca de 3 anos. Por outro lado, a escolha de estagiar numa clínica de Hemodiálise, permitiu-me aprofundar conhecimentos sobre o doente e sua família em programa de hemodiálise bem como sobre a especificidade da técnica em si. Essa aquisição de conhecimentos tem-se revelado muito importante no meu dia-a-dia na prestação de cuidados aos doentes em estado crítico com necessidade de técnicas de substituição renal contínuas. No Serviço de Urgência, adquiri conhecimentos e competências nos seus diferentes contextos, desde o Serviço de Observação à Sala de Reanimação, o que permitiu obter uma visão mais abrangente de todo o percurso do doente crítico desde a sua entrada no Hospital. No estágio em Unidade de Cuidados Pós-Anestésicos, mobilizei e desenvolvi conhecimentos sobre especificidades dos doentes em falência multiorgânica e sobre cuidados no transporte do doente crítico para o Bloco Operatório ou para a Unidade de Cuidados Intensivos. 8 Na Clínica de Hemodiálise, desenvolvi competências especializadas no que diz respeito aos cuidados à pessoa com doença renal crónica em programa de hemodiálise, como por exemplo os cuidados especializados com os acessos vasculares. Durante a realização dos estágios, deparei-me de forma recorrente com a necessidade de estudar e utilizar os mecanismos de prevenção da deterioração fisiológica dos doentes, sendo como tal este o tema principal do presente relatório. Durante o meu percurso na Unidade de Cuidados Intensivos enquanto enfermeira e estudante de mestrado, senti a necessidade de elaborar uma revisão da literatura acerca das intervenções de Enfermagem ao doente em Prone Position, que traduz uma intervenção de grande complexidade e recorrência no meu dia-a-dia. A revisão apresenta não só as intervenções de enfermagem para a técnica referida como também as contraindicações da mesma.
This report demonstrates the development of specialized skills in medical-surgical nursing in intensive care during my training program. Throughout this work placement, I provided specialized care to critically ill patients and their family, in different contexts. I also developed team training skills through in-service training, thus contributing to the improvement of patient care and safety by means of the professional development of nurses. The internship was divided into three fields: Emergency Department, Post Anesthetic Care Unit (UCPA) and Hemodialysis Clinic, the choice of which derived from the need to better understand the path of critical patients and to combine this with my two-year work experience in an internal medicine ward and a nearly three year experience in a multipurpose intensive care unit. On the other hand, choosing to undertake my internship at an hemodyalisis clinic allowed me to develop my understanding of the struggles and challenges of nursing care of patients with renal failure, as well as of the specificities of hemodyalisis techniques. This has proven fundamental in my daily work in the treatment of critically ill patients with continuous renal replacement therapy. Firstly, in the emergency department, I acquired skills and knowledge allowing me to gain a broader view of the entire path of a critical patient as soon as he/she enters the hospital. My experience at the UCPA, in turn, was key to acquire and consolidate my know how concerning the specificities of surgical users in multiorgan failure, the stabilization of these same users and the transport to the operating room or to the ICU. Finally, in the hemodialysis clinic, I developed specialized skills in relation to patients with chronic kidney disease undergoing dialysis, such as learning specialized care techniques with regard to vascular accesses. 10 Throughout the above internships, I was able to grasp the importance of studying and working with tools aiming to prevent the physiological deterioration of patients. Hence, this has been the main topic of this report. During my journey at the ICU and as a nurse attending a postgraduate degree, I felt the need to devise a research paper about the nursing interventions to patients in Prone Position, a topic which has also been included in this report, which requires a skill set of great complexity and carries great importance in my day to day work. The review undertaken focuses not only on these nursing techniques but also on their limitations.
This report demonstrates the development of specialized skills in medical-surgical nursing in intensive care during my training program. Throughout this work placement, I provided specialized care to critically ill patients and their family, in different contexts. I also developed team training skills through in-service training, thus contributing to the improvement of patient care and safety by means of the professional development of nurses. The internship was divided into three fields: Emergency Department, Post Anesthetic Care Unit (UCPA) and Hemodialysis Clinic, the choice of which derived from the need to better understand the path of critical patients and to combine this with my two-year work experience in an internal medicine ward and a nearly three year experience in a multipurpose intensive care unit. On the other hand, choosing to undertake my internship at an hemodyalisis clinic allowed me to develop my understanding of the struggles and challenges of nursing care of patients with renal failure, as well as of the specificities of hemodyalisis techniques. This has proven fundamental in my daily work in the treatment of critically ill patients with continuous renal replacement therapy. Firstly, in the emergency department, I acquired skills and knowledge allowing me to gain a broader view of the entire path of a critical patient as soon as he/she enters the hospital. My experience at the UCPA, in turn, was key to acquire and consolidate my know how concerning the specificities of surgical users in multiorgan failure, the stabilization of these same users and the transport to the operating room or to the ICU. Finally, in the hemodialysis clinic, I developed specialized skills in relation to patients with chronic kidney disease undergoing dialysis, such as learning specialized care techniques with regard to vascular accesses. 10 Throughout the above internships, I was able to grasp the importance of studying and working with tools aiming to prevent the physiological deterioration of patients. Hence, this has been the main topic of this report. During my journey at the ICU and as a nurse attending a postgraduate degree, I felt the need to devise a research paper about the nursing interventions to patients in Prone Position, a topic which has also been included in this report, which requires a skill set of great complexity and carries great importance in my day to day work. The review undertaken focuses not only on these nursing techniques but also on their limitations.
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Keywords
Clinical deterioration Early warning score Nursing care Nursing interventions