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Abstract(s)
No âmbito do programa curricular do Curso de Mestrado em Enfermagem de Natureza
Profissional, na área de Especialização em Enfermagem de Médico-Cirúrgica, realizaram-se
três períodos de estágio, com o intuito de complementar a formação teórica com a prestação
de cuidados de enfermagem especializados ao doente em estado crítico, sendo que o presente
relatório corresponde à última fase deste percurso.
A redação do presente documento assenta sobre a pesquisa da evidência, a reflexão
contínua e sistemática dos momentos de aprendizagem, as dificuldades sentidas e superadas,
no processo de aquisição de conhecimento e de desenvolvimento de competências pessoais e/
ou profissionais ao longo dos estágios realizados no Hospital de São José (Centro Hospitalar
Lisboa Central, EPE) nos seguintes serviços: Unidade de Urgência Médica, Serviço de
Urgência Polivalente e Bloco Operatório Central.
Ao longo dos estágios deu-se ênfase à prestação dos cuidados de enfermagem
especializados e à qualidade e segurança dos cuidados prestados ao doente e à sua família,
sendo que no estágio dos cuidados intensivos, os cuidados especializados foram direcionados
para os doentes em estado crítico submetidos a ventilação mecânica invasiva, para a
elaboração de uma norma de procedimentos de enfermagem ao doente portador de
traqueostomia, para a identificação de variáveis de monitorização do doente após extubação
traqueal e posterior elaboração de um instrumento de colheita de dados.
No estágio no Serviço de Urgência, a prestação de cuidados de enfermagem
especializados incidiu sobre o doente com trauma/patologia torácica, na sensibilização para
adequada manipulação dos catéteres venosos centrais totalmente implantados, na elaboração
de uma instrução de trabalho na abordagem do doente com suspeita de meningite (em
articulação com a equipa da Comissão de Controlo da Infeção do Hospital de São José) e
ainda na elaboração de um póster sobre a Capnografia não invasiva e os doentes com doença
pulmonar obstrutiva crónica.
No estágio de Enfermagem Peri-Operatória, desenvolveram-se competências aquando
da prestação de cuidados de enfermagem especializados ao doente em estado crítico
submetido a cirurgia do foro oncológico, enquanto enfermeira de anestesia e circulante em sala
de operação e na unidade de cuidados pós-anestésicos e foi elaborada uma instrução de
trabalho sobre a preparação e identificação de fármacos de acordo com o projeto ColorADD,
implementado em sala operatória.
Transversalmente aos três módulos de estágio procedeu-se à gestão de fármacos,
solutos e materiais termolábeis, de acordo com a normas da instituição e as caraterísticas de
cada serviço.
A execução das atividades inerentes aos objetivos propostos permitiram o
desenvolvimento gradual e autónomo das competências no domínio da responsabilidade
profissional, ética e legal, da melhoria contínua da qualidade, da gestão dos cuidados e das
aprendizagens profissionais caraterísticas do Enfermeiro Especialista
As part of the curriculum for the Master's Degree in Nursing of Professional Expertise in the Medical-Surgical Nursing’s area, it was held three training periods, in order to complement the theoretical training with providing skilled nursing care to the patient in critical condition, so this report represents the final stage of this route. This document is based on evidence research, systematic and continuous reflection of the learning moments, the encountered difficulties and the overcome in the process of acquiring knowledge and personal and/or professional development over the stage at the Saint Joseph’s Hospital (Central Lisbon Hospital Centre, EPE) in the following services: Emergency Medical Unit, Emergency Department and Operating Room Multipurpose Center. Throughout the stages, emphasis was placed on the provision of skilled nursing care and the quality and safety of care provided to patients and their families, and in the stage of intensive care, specialist care were targeted for critically ill patients undergoing invasive mechanical ventilation, to develop a standard nursing procedures to patient tracheostomy patient, to identify variables to monitor the patient after extubation and subsequent development of an instrument of data collection . On stage in the emergency department, the provision of skilled nursing care was focused on patients with thoracic trauma/pathology, in raising an awareness of proper handling of totally implanted central venous catheters, in drafting a statement work in management of patients with suspected meningitis (in conjunction with a team-mate and a master of the Infection Control Committee of Saint Joseph's Hospital) and also to prepare a poster about noninvasive capnography and patients with chronic obstructive pulmonary disease. In the stage of Peri-Operative Nursing, I have developed skills with the provision of skilled nursing care to patients in critical condition undergoing oncological surgery while circulating and anesthesia nurse in the operating room and in the post-anesthetic unit, but also with an instruction work on the drug’s preparation and identification according to the ColorADD design, implemented in the operating room. Across the three modules it has been proceeded to the stage management of thermolabile drugs, solutes and materials, according to the institution´s regulation and each service´s characteristics. The activities, relating to the proposed objetives, allowed the gradual development of autonomous powers in the field of professional responsibility, ethics and legal continuous improvement of quality care management and learning professionals features of the Specialist Nurse.
As part of the curriculum for the Master's Degree in Nursing of Professional Expertise in the Medical-Surgical Nursing’s area, it was held three training periods, in order to complement the theoretical training with providing skilled nursing care to the patient in critical condition, so this report represents the final stage of this route. This document is based on evidence research, systematic and continuous reflection of the learning moments, the encountered difficulties and the overcome in the process of acquiring knowledge and personal and/or professional development over the stage at the Saint Joseph’s Hospital (Central Lisbon Hospital Centre, EPE) in the following services: Emergency Medical Unit, Emergency Department and Operating Room Multipurpose Center. Throughout the stages, emphasis was placed on the provision of skilled nursing care and the quality and safety of care provided to patients and their families, and in the stage of intensive care, specialist care were targeted for critically ill patients undergoing invasive mechanical ventilation, to develop a standard nursing procedures to patient tracheostomy patient, to identify variables to monitor the patient after extubation and subsequent development of an instrument of data collection . On stage in the emergency department, the provision of skilled nursing care was focused on patients with thoracic trauma/pathology, in raising an awareness of proper handling of totally implanted central venous catheters, in drafting a statement work in management of patients with suspected meningitis (in conjunction with a team-mate and a master of the Infection Control Committee of Saint Joseph's Hospital) and also to prepare a poster about noninvasive capnography and patients with chronic obstructive pulmonary disease. In the stage of Peri-Operative Nursing, I have developed skills with the provision of skilled nursing care to patients in critical condition undergoing oncological surgery while circulating and anesthesia nurse in the operating room and in the post-anesthetic unit, but also with an instruction work on the drug’s preparation and identification according to the ColorADD design, implemented in the operating room. Across the three modules it has been proceeded to the stage management of thermolabile drugs, solutes and materials, according to the institution´s regulation and each service´s characteristics. The activities, relating to the proposed objetives, allowed the gradual development of autonomous powers in the field of professional responsibility, ethics and legal continuous improvement of quality care management and learning professionals features of the Specialist Nurse.