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Abstract(s)
O presente relatório surge no âmbito do 11º 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. Foi elaborado segundo uma metodologia
descritiva e crítico-reflexiva com o intuito de transmitir as principais experiências e aprendizagens desenvolvidas no estágio nos contextos de Cuidados Intensivos e Cuidados Intermédios, no período de 04/02/2019 a 25/05/2019, que possibilitaram o desenvolvimento das Competências Comuns e Específicas do Enfermeiro Especialista em Enfermagem Médico-Cirúrgica, na área de especialidade referida.
Nos domínios das competências comuns evidenciou-se o compromisso ético, legal e profissional nos cuidados ao doente e família, prezando o respeito pela sua autonomia e dignidade. Para uma melhoria contínua da qualidade sustentou-se a prática baseada na evidência científica atual, promovendo um ambiente terapêutico e seguro. Na gestão dos cuidados procurou-se conhecer a dinâmica organizacional
e funcional dos locais de estágio, otimizando as respostas de enfermagem. O desenvolvimento das aprendizagens profissionais é transversal a todo o relatório e a reflexão sobre as experiências levou a um processo de autoaprendizagem, que culminou no desenvolvimento das competências pretendidas. Das oportunidades de melhoria identificadas, incidiu-se sobre a prevenção do delirium, pela sua prevalência e importância, levando a uma revisão da literatura e, posteriormente, a sessões de formação realizadas nos 2 contextos de prática com foco nas medidas não farmacológicas para a sua prevenção e tratamento. A pessoa em situação crítica e sua família constituiu o alvo dos cuidados de enfermagem. A falência ou a eminência de disfunções de funções vitais infligem na pessoa e família sentimentos de dor, perda, medo e ansiedade. Estes sentimentos e disfunções orgânicas traduziram-se em focos de atenção do enfermeiro especialista na área, promovendo um cuidado humanizado e qualificado. Dada a suscetibilidade da pessoa em situação crítica à infeção associada aos cuidados de saúde, evidenciou-se a importância do papel do enfermeiro especialista na sua prevenção e controlo a vários níveis, dos quais se destaca a implementação dos feixes de intervenção preconizados pela Direção-Geral da Saúde. O percurso desenvolvido traduziu-se num saber competente e altruísta, capaz de prever e detetar precocemente complicações, de assegurar uma intervenção concreta, eficiente e em tempo útil, refletindo a melhoria da qualidade e humanização nos cuidados prestados.
The present report is the culmination of the 11th Master's degree in Nursing with Specialization in Medical-Surgical Nursing, in the area of nursing for people in critical situations, from the School of Nursing-Porto of the Universidade Católica Portuguesa. It was developed according to a descriptive and critical-reflexive methodology in order to transmit the main experiences and learning developed in the internship in the contexts of the Intensive Care and Intermediate Care Units, from 04/02/2019 to 25/05/2019, that permitted the development of the Common and Specific Competencies of the Specialist Nurse in Medical-Surgical Nursing, in the area of her specialization. The common competences, the ethical, legal, and professional commitment to patient and family care was highlighted, with due regard for their autonomy and dignity. For a continuous improvement of quality, the practice was based on current scientific evidence, promoting a therapeutic and safe environment. To achieve that quality, we sought the organizational and functional dynamics of the internship locations, with the objective of optimizing the nursing responses. The development of the professional learning process is transversal to the entire report and the reflection on the experiences led to a process of self-learning, which culminated in the development of the desired skills. Among the identified improvement opportunities, the focus was on the prevention of delirium, due to its frequency and importance, leading to a literature review and, subsequently, to training sessions held in the 2 contexts of practice with a focus on non-pharmacological measures for its prevention and treatment. The critical patient and his family were the target of nursing care. The failure or the imminence of dysfunction of vital functions inflicts feelings of pain, loss, fear and anxiety on the person and family. These feelings and organic dysfunctions were the focus of attention of the specialist nurse, promoting humanized and qualified care. Given the susceptibility of the critically ill patient to health care-associated infections, the importance of the specialist nurse's role in its prevention and control at various levels was highlighted, of which the implementation of the intervention bundles recommended by the Portuguese Directorate-General of Health stands out. The path that was developed led to a competent and altruistic knowledge, capable of predicting and detecting complications early, of ensuring a concrete, efficient and timely intervention, reflecting the improvement of quality and humanization in the care provided.
The present report is the culmination of the 11th Master's degree in Nursing with Specialization in Medical-Surgical Nursing, in the area of nursing for people in critical situations, from the School of Nursing-Porto of the Universidade Católica Portuguesa. It was developed according to a descriptive and critical-reflexive methodology in order to transmit the main experiences and learning developed in the internship in the contexts of the Intensive Care and Intermediate Care Units, from 04/02/2019 to 25/05/2019, that permitted the development of the Common and Specific Competencies of the Specialist Nurse in Medical-Surgical Nursing, in the area of her specialization. The common competences, the ethical, legal, and professional commitment to patient and family care was highlighted, with due regard for their autonomy and dignity. For a continuous improvement of quality, the practice was based on current scientific evidence, promoting a therapeutic and safe environment. To achieve that quality, we sought the organizational and functional dynamics of the internship locations, with the objective of optimizing the nursing responses. The development of the professional learning process is transversal to the entire report and the reflection on the experiences led to a process of self-learning, which culminated in the development of the desired skills. Among the identified improvement opportunities, the focus was on the prevention of delirium, due to its frequency and importance, leading to a literature review and, subsequently, to training sessions held in the 2 contexts of practice with a focus on non-pharmacological measures for its prevention and treatment. The critical patient and his family were the target of nursing care. The failure or the imminence of dysfunction of vital functions inflicts feelings of pain, loss, fear and anxiety on the person and family. These feelings and organic dysfunctions were the focus of attention of the specialist nurse, promoting humanized and qualified care. Given the susceptibility of the critically ill patient to health care-associated infections, the importance of the specialist nurse's role in its prevention and control at various levels was highlighted, of which the implementation of the intervention bundles recommended by the Portuguese Directorate-General of Health stands out. The path that was developed led to a competent and altruistic knowledge, capable of predicting and detecting complications early, of ensuring a concrete, efficient and timely intervention, reflecting the improvement of quality and humanization in the care provided.
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Keywords
Enfermagem Médico-Cirúrgica Competências Cuidados Intensivos Pessoa em situação crítica Delirium Medical-Surgical Nursing Competencies Critical Care Critical care patient