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Abstract(s)
O presente Relatório de Estágio surge no âmbito do Curso de Mestrado em Enfermagem com Especialização em Enfermagem Médico-Cirúrgica da Universidade Católica Portuguesa – Porto, como o culminar do estágio final, realizado na Unidade de Cuidados Intensivos Coronários e Serviço de Urgência de um hospital da Região Norte de Portugal. A crescente diversidade e complexidade dos problemas de saúde, a par do aumento da exigência da qualidade na assistência, colocam o enfermeiro perante a necessidade de saber intervir junto à pessoa em situação crítica. Nestes contextos, é essencial que esteja desperto, além da execução dos cuidados técnicos de alta complexidade, para a relação de ajuda e para a humanidade. A interação com o doente crítico e família requer do enfermeiro a maturidade, conhecimento de si próprio e reconhecimento das suas limitações, bem como uma abertura à aprendizagem contínua, promovendo simultaneamente a aquisição de competências especializadas e a excelência do cuidado. As doenças cardiovasculares, particularmente o Enfarte Agudo do Miocárdio, são a principal causa de morte em Portugal, mantendo-se no topo das prioridades do planeamento em saúde. A Via Verde Coronária permite o rápido acesso a cuidados diferenciados, diminuindo barreiras burocráticas e implementando protocolos de atuação. No sentido de proporcionar ao doente os melhores tratamentos disponíveis, e considerando a rede de referenciação de cardiologia nacional, tem aumentado a necessidade de realização de transporte inter-hospitalar de doentes críticos. Verificou-se, em contexto clínico, a inexistência de um documento de registos de enfermagem relativos à evolução do estado clínico do doente e terapêutica administrada durante o transporte. Com base nas recomendações atuais para o transporte de doentes críticos foi elaborado um documento para a realização desses registos de enfermagem, permitindo uniformização de práticas e auditorias, visando a melhoria da qualidade dos cuidados e a excelência no exercício da profissão. A proteção da intimidade e da privacidade dos doentes pode ser uma questão complexa em contexto de urgência/emergência. A privacidade é para o doente uma necessidade e um direito, indispensável à manutenção da sua dignidade, tendo o enfermeiro a responsabilidade de a salvaguardar. Sabendo que gerir é cuidar mesmo antes de o doente chegar ao hospital, o enfermeiro especialista tem um papel preponderante na gestão de toda a logística do serviço que o vai acolher, incluindo na proteção deste direito. A teoria Nursing as Caring de Boykin e Schoenhofer alicerçou o pensamento e a atividade no cuidar do doente crítico, perspetivando o cuidar como inerente a ser-se humano, mas vivido de uma forma muito particular e consciente pelo enfermeiro, potenciando o seu crescimento pessoal e profissional em colaboração estreita com a pessoa alvo dos seus cuidados. O Curso de Mestrado possibilitou o desenvolvimento de competências especializadas que afiançam cuidados de enfermagem de qualidade e ganhos em saúde através do aperfeiçoamento do processo de tomada de decisão, assente na ação refletida baseada na evidência, contribuindo naturalmente para o desenvolvimento pessoal e profissional.
The present Traineeship Report is presented in the scope of the Master’s Course in Nursing with Specialization in Medical-Surgical Nursing of the Portuguese Catholic University - Porto, as the culmination of the professional traineeship, performed at the Coronary Intensive Care Unit and Emergency Department of a hospital of the North Region of Portugal. The increasing diversity and complexity of health problems, coupled with the increase in the quality of care, place the nurses towards the need of knowing how to intervene with the person in critical situation. In these contexts, it is essential to be aware, beyond the execution of the highly complex technical care, to the aid relationship and to humanity. Interaction with the critical patient and family requires nurses to be mature, self-aware and aware of their limitations, as well as an openness to continuous learning, while promoting the acquisition of specialized skills and excellence in care. Cardiovascular diseases, particularly Acute Myocardial Infarction, are the leading cause of death in Portugal, standing at the top of health planning priorities. The Coronary Fast Track allows quick access to differentiated care, reducing bureaucratic barriers and implementing protocols of action. In order to provide the patient with the best available treatments, and considering the national cardiology referral network, the need for inter-hospital transport of critical patients has increased. It was verified, in clinical context, the inexistence of a nursing record document regarding the evolution of the patient's clinical status and therapy administered during transport. Based on the current recommendations for the transport of critical patients, a document was elaborated for the accomplishment of these registers of nursing, allowing standardization of practices and audits, aiming at the improvement of the quality of the care and the excellence in the exercise of the profession. Protecting the intimacy and privacy of patients can be a complex issue in urgency/emergency. Privacy is for the patient a need and a right, indispensable to the maintenance of his dignity, and the nurse has the responsibility to safeguard it. Knowing that managing is caring even before the patient arrives at the hospital, the specialist nurse has a preponderant role in managing all the logistics of the service that will host him, including the protection of this right. The Nursing as Caring theory of Boykin and Schoenhofer underpinned the thinking and activity in caring for the critical patient, looking at caring as inherent to being human, but lived in a very particular and conscious way by the nurses, enhancing their personal growth and professional relationship in close collaboration with the person targeted for their care. The Master's degree course allowed the development of specialized skills that ensure quality nursing care and health gains through the improvement of the decision-making process, based on reflected action based on evidence, contributing naturally to personal and professional development.
The present Traineeship Report is presented in the scope of the Master’s Course in Nursing with Specialization in Medical-Surgical Nursing of the Portuguese Catholic University - Porto, as the culmination of the professional traineeship, performed at the Coronary Intensive Care Unit and Emergency Department of a hospital of the North Region of Portugal. The increasing diversity and complexity of health problems, coupled with the increase in the quality of care, place the nurses towards the need of knowing how to intervene with the person in critical situation. In these contexts, it is essential to be aware, beyond the execution of the highly complex technical care, to the aid relationship and to humanity. Interaction with the critical patient and family requires nurses to be mature, self-aware and aware of their limitations, as well as an openness to continuous learning, while promoting the acquisition of specialized skills and excellence in care. Cardiovascular diseases, particularly Acute Myocardial Infarction, are the leading cause of death in Portugal, standing at the top of health planning priorities. The Coronary Fast Track allows quick access to differentiated care, reducing bureaucratic barriers and implementing protocols of action. In order to provide the patient with the best available treatments, and considering the national cardiology referral network, the need for inter-hospital transport of critical patients has increased. It was verified, in clinical context, the inexistence of a nursing record document regarding the evolution of the patient's clinical status and therapy administered during transport. Based on the current recommendations for the transport of critical patients, a document was elaborated for the accomplishment of these registers of nursing, allowing standardization of practices and audits, aiming at the improvement of the quality of the care and the excellence in the exercise of the profession. Protecting the intimacy and privacy of patients can be a complex issue in urgency/emergency. Privacy is for the patient a need and a right, indispensable to the maintenance of his dignity, and the nurse has the responsibility to safeguard it. Knowing that managing is caring even before the patient arrives at the hospital, the specialist nurse has a preponderant role in managing all the logistics of the service that will host him, including the protection of this right. The Nursing as Caring theory of Boykin and Schoenhofer underpinned the thinking and activity in caring for the critical patient, looking at caring as inherent to being human, but lived in a very particular and conscious way by the nurses, enhancing their personal growth and professional relationship in close collaboration with the person targeted for their care. The Master's degree course allowed the development of specialized skills that ensure quality nursing care and health gains through the improvement of the decision-making process, based on reflected action based on evidence, contributing naturally to personal and professional development.
Description
Keywords
Doente crítico Enfarte agudo do miocárdio Transporte inter-hospitalar Privacidade Critical patient Nursing as caring Acute myocardial infarction Inter-hospital transport Privacy