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Um percurso formativo de aquisição de competências especializadas
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Este Relatório de Estágio foi desenvolvido no âmbito do Curso de Mestrado em Enfermagem com área de Especialização em Enfermagem Médico-Cirúrgica: Pessoa em Situação Crítica, do Instituto de Ciências da Saúde da Universidade Católica Portuguesa. Pretende-se com o mesmo uma reflexão crítica que permita o desenvolvimento profissional das áreas de competência do Enfermeiro Especialista. A descrição e reflexão dos momentos de aprendizagem relativos às competências comuns e especificas do Enfermeiro Especialista em Enfermagem Médico-Cirúrgica na vertente do doente crítico e também a aquisição de competências na área da Investigação em Saúde. Numa primeira fase, realiza-se uma Revisão Bibliográfica que demonstra a importância da avaliação do Risco Nutricional no doente Oncológico adulto em contexto hospitalar. Seguidamente é realizada uma descrição do contexto de Serviço de Urgência e Unidade de Cuidados Pós-Anestésicos, onde se desenvolveram as horas práticas de contacto e onde houve oportunidade de desenvolver atividades e planos de cuidados que permitiram adquirir as competências necessárias à especialização. A implementação de estratégias e intervenções que previnem e tratam a desnutrição é essencial em qualquer doente em contexto de internamento, mas assume uma importância vital em doentes do foro oncológico. Estes doentes apresentam logo à partida uma predisposição para a desnutrição, não só pela própria doença em si, mas também pelos efeitos secundários e consequências dos tratamentos como a quimioterapia, a radioterapia e a cirurgia. A desnutrição agrava e condiciona a resposta aos mesmos e pode levar à instabilidade hemodinâmica destes doentes, pelo que uma intervenção especializada baseada na mais recente evidência científica se constitui de grande importância. Esta é uma área da saúde que assume cada vez mais relevo na realidade Mundial, sendo que as neoplasias representam a segunda maior causa de morte em Portugal e no Mundo. Desta forma, doentes com diagnóstico de cancro são cada vez mais representativos a nível hospitalar. O desenvolvimento de novas formas de tratamento faz com que estes doentes requeiram cuidados especializados, tanto a nível médico como cirúrgico, em fases diferentes da sua doença necessitando muitas vezes de cuidados em situação crítica. Pode, assim, concluir-se que a Desnutrição é um problema comum a nível hospitalar, mas é ainda mais evidente e crítico em doentes oncológicos, condicionando a evolução do seu estado de saúde, sendo a avaliação do Risco Nutricional a primeira intervenção de enfermagem a ser implementada com o objetivo de lidar com este problema. Após esta revisão bibliográfica desenvolveu-se um trabalho reflexivo onde se pretende mostrar o percurso que levou à aquisição de competências especializadas, centradas na pessoa a vivenciar processos de saúde/doença aguda ou crónica, gerindo e otimizando recursos que visam dar resposta ás necessidades identificadas de forma a prevenir ou tratar de forma rápida e eficaz os problemas, a gestão de situações de catástrofe e emergência e prevenção e atuação no controlo da infeção. Conclui-se, assim, que o caminho para a enfermagem especializada é feito através da reflexão da prática e da sua base em evidência científica comprovada.
This Report was developed as part of the Master's Degree in Nursing with a Specialization in Medical-Surgical Nursing: Critically ill people and their families, at the Institute of Health Sciences of the Portuguese Catholic University. The aim is to provide a critical reflection that will enable professional development in the areas of competence of the Specialist Nurse. It tries to describe and reflect on the learning moments relating to the common and specific competences of the Specialist Nurse in Medical-Surgical Nursing in the area of the critically ill patient and also the acquisition of competences in the area of Health Research. In the first phase, a Bibliographic Review is carried out and demonstrates the importance of assessing Nutritional Risk in adult oncology patients in a hospital setting. This is followed by a description of the context of the Emergency Department and PostAnesthetic Care Unit, where the practical contact hours were carried out and where there was the opportunity to develop activities and care plans that enabled the skills required for specialization to be acquired. Implementing strategies and interventions to prevent and treat malnutrition is essential for any patient admitted to a hospital care facility, but it is vitally important for cancer patients. These patients are predisposed for malnutrition from the outset, not only because of the disease itself, but also because of the side effects and consequences of treatments such as chemotherapy, radiotherapy and surgery. Malnutrition aggravates and conditions the response to these treatments and can lead to hemodynamic instability in these patients, which is why specialized intervention based on the latest scientific evidence is of great importance. This is a health problem that is becoming increasingly important in the world, with neoplasic diseases representing the second largest cause of death in Portugal and in the World. Patients diagnosed with cancer are therefore becoming increasingly common in hospitals. The development of new forms of treatment means that these patients require very specialized medical and surgical care at different stages of their illness, often requiring critical care. It can be concluded that malnutrition is a common problem at patients admitted to a hospital, but it is even more evident and critical in cancer patients, conditioning the evolution of their state of health the assessment of Nutritional Risk is the first nursing intervention to be implemented in order to deal with this problem. After this bibliographic review, a reflexive work was developed to show the path that led to the acquisition of specialized skills, focused on the person experiencing acute or chronic health/illness processes, managing and optimizing resources aimed at responding to identify needs in order to prevent or treat problems quickly and effectively, managing disaster and emergency situations and preventing and acting in infection control. Therefore, it is concluded that the path to specialized nursing is made through reflection on practice and has its basis in proven scientific evidence.
This Report was developed as part of the Master's Degree in Nursing with a Specialization in Medical-Surgical Nursing: Critically ill people and their families, at the Institute of Health Sciences of the Portuguese Catholic University. The aim is to provide a critical reflection that will enable professional development in the areas of competence of the Specialist Nurse. It tries to describe and reflect on the learning moments relating to the common and specific competences of the Specialist Nurse in Medical-Surgical Nursing in the area of the critically ill patient and also the acquisition of competences in the area of Health Research. In the first phase, a Bibliographic Review is carried out and demonstrates the importance of assessing Nutritional Risk in adult oncology patients in a hospital setting. This is followed by a description of the context of the Emergency Department and PostAnesthetic Care Unit, where the practical contact hours were carried out and where there was the opportunity to develop activities and care plans that enabled the skills required for specialization to be acquired. Implementing strategies and interventions to prevent and treat malnutrition is essential for any patient admitted to a hospital care facility, but it is vitally important for cancer patients. These patients are predisposed for malnutrition from the outset, not only because of the disease itself, but also because of the side effects and consequences of treatments such as chemotherapy, radiotherapy and surgery. Malnutrition aggravates and conditions the response to these treatments and can lead to hemodynamic instability in these patients, which is why specialized intervention based on the latest scientific evidence is of great importance. This is a health problem that is becoming increasingly important in the world, with neoplasic diseases representing the second largest cause of death in Portugal and in the World. Patients diagnosed with cancer are therefore becoming increasingly common in hospitals. The development of new forms of treatment means that these patients require very specialized medical and surgical care at different stages of their illness, often requiring critical care. It can be concluded that malnutrition is a common problem at patients admitted to a hospital, but it is even more evident and critical in cancer patients, conditioning the evolution of their state of health the assessment of Nutritional Risk is the first nursing intervention to be implemented in order to deal with this problem. After this bibliographic review, a reflexive work was developed to show the path that led to the acquisition of specialized skills, focused on the person experiencing acute or chronic health/illness processes, managing and optimizing resources aimed at responding to identify needs in order to prevent or treat problems quickly and effectively, managing disaster and emergency situations and preventing and acting in infection control. Therefore, it is concluded that the path to specialized nursing is made through reflection on practice and has its basis in proven scientific evidence.
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Desnutrição Risco nutricional Enfermagem especializada Intervenções de enfermagem Malnutrition Nutritional risk Specialized nursing Nursing interventions
Contexto Educativo
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Licença CC
Sem licença CC