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Imobilização da pessoa com suspeita de traumatismo vertebro-medular
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O presente relatório surge no âmbito da Unidade Curricular “Estágio Final e Relatório” do 15º Mestrado em Enfermagem Médico-Cirúrgica, na área de Especialização à Pessoa em Situação Crítica, na Escola de Enfermagem (Lisboa) do Instituto de Ciências da Saúde da Universidade Católica Portuguesa e tem como objetivo a obtenção do grau de Mestre em enfermagem e o título de Enfermeira Especialista em Enfermagem Médico-Cirúrgica na área da enfermagem à Pessoa em Situação Crítica. Nele pretendo descrever os objetivos e atividades desenvolvidas nos estágios, além das competências de mestre, competências comuns e competências específicas de enfermeira especialista adquiridas e desenvolvidas nesses contextos, através de uma metodologia descritiva e crítico-reflexiva com recurso a pesquisa bibliográfica para fundamentação científica. O referencial teórico do relatório e da prática de cuidados à pessoa em situação crítica nos contextos de estágio é a teoria das necessidades humanas fundamentais de Virginia Henderson. Quanto à estrutura do relatório, na introdução definem-se alguns conceitos principais. No primeiro capítulo é feita uma scoping review sobre a imobilização com plano duro do adulto com suspeita de traumatismo vertebro-medular no pré-hospitalar e serviço de urgência, com vista ao desenvolvimento de competências de mestre, especificamente em investigação. Os estágios neste percurso académico e profissional foram realizados numa unidade de cuidados intensivos neurocríticos e numa unidade de cuidados intensivos polivalente num hospital da área de Lisboa e no segundo capítulo é feita a caracterização de ambos os locais. No terceiro exponho os objetivos definidos em cada estágio e é dado realce às atividades efetuadas para os atingir, através da descrição e análise reflexiva das mesmas para desenvolver as competências de mestre e enfermeira especialista em enfermagem médico-cirúrgica à pessoa em situação crítica, realçando as unidades de competência da antecipação da instabilidade, administração de protocolos terapêuticos complexos e prevenção e controlo de infeção. Na conclusão é feita uma reflexão sobre o desenvolvimento profissional alcançado com base nas competências adquiridas e desenvolvidas neste percurso, rematando que este percurso contribuiu para evolução dinâmica da minha prática de cuidados de enfermagem especializados.
The present report arises within the scope of the 15th Master’s Degree in Medical-Surgical Nursing in the Specialization area of the Person with Critical Illness at the Nursing School (Lisbon) of the Institute of Health Sciences from the Portuguese Catholic University and it aims to obtain a master’s degree and the title of nurse specialist in medical-surgical nursing in the area of person with critical illness. On it I intend to describe the goals and activities conducted in the internships: master skills, common competencies and specific competencies of nurse specialist acquired and developed in those contexts through a descriptive and critical-reflective methodology using bibliographic research for scientific substantiation. Virginia Henderson’s theory of human needs was the theoretical support for this report and the practice of nursing care to the person with critical illness in the internships. Regarding the structure of this report, in the introduction some essential concepts are defined. Next, in the first chapter, it is produced a scoping review about the immobilization with backboard of adults with suspected spinal cord injury in pre-hospital care and emergency department for the development of master skills, specifically in research. In this academic and professional path internships were carried out in two units: neurocritical intensive care unit and medical-surgical intensive care unit in a hospital in the Lisbon area and in the second chapter a characterization of both internship units is made. In the third chapter I expose the goals defined for each internship and highlight the activities carried out to achieve them through their description and reflective analysis in order to develop master’s skills and competencies of a specialist nurse in medical-surgical nursing for person with critical illness, highlighting the anticipation of instability, administering complex therapeutic protocols and prevention and control of infection. Lastly, in the conclusion, a reflection is made on the professional development achieved based on the skills acquired and developed along this path, reckoning that this path has contributed for de dynamic evolution of my specialized nursing practice.
The present report arises within the scope of the 15th Master’s Degree in Medical-Surgical Nursing in the Specialization area of the Person with Critical Illness at the Nursing School (Lisbon) of the Institute of Health Sciences from the Portuguese Catholic University and it aims to obtain a master’s degree and the title of nurse specialist in medical-surgical nursing in the area of person with critical illness. On it I intend to describe the goals and activities conducted in the internships: master skills, common competencies and specific competencies of nurse specialist acquired and developed in those contexts through a descriptive and critical-reflective methodology using bibliographic research for scientific substantiation. Virginia Henderson’s theory of human needs was the theoretical support for this report and the practice of nursing care to the person with critical illness in the internships. Regarding the structure of this report, in the introduction some essential concepts are defined. Next, in the first chapter, it is produced a scoping review about the immobilization with backboard of adults with suspected spinal cord injury in pre-hospital care and emergency department for the development of master skills, specifically in research. In this academic and professional path internships were carried out in two units: neurocritical intensive care unit and medical-surgical intensive care unit in a hospital in the Lisbon area and in the second chapter a characterization of both internship units is made. In the third chapter I expose the goals defined for each internship and highlight the activities carried out to achieve them through their description and reflective analysis in order to develop master’s skills and competencies of a specialist nurse in medical-surgical nursing for person with critical illness, highlighting the anticipation of instability, administering complex therapeutic protocols and prevention and control of infection. Lastly, in the conclusion, a reflection is made on the professional development achieved based on the skills acquired and developed along this path, reckoning that this path has contributed for de dynamic evolution of my specialized nursing practice.
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Keywords
Pessoa em situação crítica Enfermeiro especialista Traumatismo vertebro-medular Prática baseada na evidência Critical illness Nurse specialist Traumatic spinal injuries Traumatic spinal cord injuries Evidence-based practice