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O presente relatório retrata o processo evolutivo de aquisição e desenvolvimento de conhecimentos e competências, para a prestação de cuidados especializados, à pessoa adulta e idosa, com doença grave e em situação crítica, durante o contexto de estágio: prestação de cuidados ao doente crítico no pré-hospitalar e em cuidados intensivos. Percurso esse, orientado pela temática, “O impacto dos cuidados especializados de enfermagem na promoção da qualidade de vida na pessoa em situação crítica”. Para a caracterização desta experiência, foi peremptório a utilização de uma metodologia descritivo-reflexiva, para analisar e dar resposta às situações vivenciadas, à luz do melhor conhecimento científico. Em ambos os contextos o juízo crítico imperou, permitindo a identificação de situações problema, a sua análise e devida proposta de melhoria, em discussão com os pares. Situações desde a prestação direta de cuidados à gestão de recursos e da qualidade. Todo este processo dinâmico é, de certa forma, narrado nos capítulos que se seguem, evidenciando as escolhas realizadas, reflexões, atividades desenvolvidas e competências adquiridas. As oportunidades de intervenção e de melhoria detetadas, prescreveram a realização de dois trabalhos pertinentes para a prática e atuais, “A aplicação do National Early Warning Score em contexto pré-hospitalar” e “Unidade de Cuidados Intensivos de portas abertas” e que vão ser retratados posteriormente. Descrevem-se, do mesmo modo, consideráveis aprendizagens transversais a todas as áreas de atuação: comunicação de más notícias, segurança do medicamento, controle de infeção, estratificação de risco clínico, dotações seguras, gestão da dor e gestão de recursos. Identificando em cada item, oportunidades de melhoria e o desenvolvimento de estratégias de resolução de situações-problema, baseado na sustentação teórica e reflexão entre pares. Partilha-se a cogitação sobre percurso construído, as implicações para a prática profissional e principais contributos individuais.
This report portrays the process that enabled the development of knowledge and skills of specialized caregiving (towards adults and the elderly, in severe sickness and the critically ill). This took place in two apprenticeships: care of the critically ill patient before admittance to Hospital and in the Intensive Care Unit. The whole journey was guided by the theme “The impact of specialized nursing care in promoting quality of life in the critically ill patient”. To better characterize the experience, the use of a descriptive and reflexive methodology became imperative. This enables the analysis of the experienced situations in the light of current and accurate scientific knowledge. Critical judgment and discussion with piers was key in both contexts, allowing the identification of problems, its analysis, and due plans for improvement. The situations ranged from direct caregiving to resource and quality management. The following chapters narrate this dynamic process, highlighting the choices that were made, reflections, activities that were developed and acquired competencies. The detected opportunities for improvement resulted in two pertinent and current essays, “The application of the National Early Warning Score in prehospital context” and “ICU with open doors”. These are portrayed later. There were considerable learning moments throughout all the areas of care, such as communicating bad news, medication safety, infection control, clinical risk stratification, safe appropriations, pain management and resource management. Each subject offered the opportunity for improvement and the development of problem-solving strategies, based on theoretical support and reflection among peers. A reflection on the journey is shared, its implications for professional practice, and main personal contributions.
This report portrays the process that enabled the development of knowledge and skills of specialized caregiving (towards adults and the elderly, in severe sickness and the critically ill). This took place in two apprenticeships: care of the critically ill patient before admittance to Hospital and in the Intensive Care Unit. The whole journey was guided by the theme “The impact of specialized nursing care in promoting quality of life in the critically ill patient”. To better characterize the experience, the use of a descriptive and reflexive methodology became imperative. This enables the analysis of the experienced situations in the light of current and accurate scientific knowledge. Critical judgment and discussion with piers was key in both contexts, allowing the identification of problems, its analysis, and due plans for improvement. The situations ranged from direct caregiving to resource and quality management. The following chapters narrate this dynamic process, highlighting the choices that were made, reflections, activities that were developed and acquired competencies. The detected opportunities for improvement resulted in two pertinent and current essays, “The application of the National Early Warning Score in prehospital context” and “ICU with open doors”. These are portrayed later. There were considerable learning moments throughout all the areas of care, such as communicating bad news, medication safety, infection control, clinical risk stratification, safe appropriations, pain management and resource management. Each subject offered the opportunity for improvement and the development of problem-solving strategies, based on theoretical support and reflection among peers. A reflection on the journey is shared, its implications for professional practice, and main personal contributions.
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Enfermagem médico-cirúrgica Enfermagem de cuidados críticos Enfermagem baseada em evidências Vulnerabilidade em saúde Medical-surgical nursing Critical care nursing Evidence-based nursing Health vulnerability