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Um cuidar especializado da pessoa em situação crítica e/ou com insuficiência renal crónica
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O presente relatório insere-se no âmbito da unidade curricular – Estágio Final e Relatório, do 17º 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. O estágio foi realizado em dois contextos distintos, decorrendo inicialmente, num serviço de urgência e, posteriormente, num serviço de cuidados intensivos, ambos em hospitais centrais na região norte do país. O principal objetivo deste relatório consiste na descrição e análise crítico-reflexiva do processo de aprendizagem, com desenvolvimento e integração de saberes na prestação de cuidados de enfermagem à pessoa em situação crítica. Para a sua elaboração, foi adotada uma metodologia descritiva e reflexiva, sustentada por uma revisão bibliográfica criteriosa. A estrutura do presente relatório encontra-se segmentada em três partes principais. A primeira corresponde à Introdução, na qual foi realizado um enquadramento geral do relatório e do estágio, a justificação das escolhas efetuadas e a apresentação dos objetivos delineados. A segunda parte é dedicada à descrição dos contextos de estágio e às Competências no Cuidado Especializado da Pessoa em Situação Crítica e/ou com Insuficiência Renal Crónica, abrangendo a descrição e análise crítico-reflexiva das atividades realizadas ao longo do percurso formativo. Por fim, a Conclusão apresenta uma síntese global, com a análise transversal dos contributos, aprendizagens adquiridas e dificuldades enfrentadas no estágio. Os contributos em cada contexto de estágio corresponderam às oportunidades de melhoria identificadas e aos objetivos de aprendizagem definidos, favorecendo a consolidação de competências e o aperfeiçoamento contínuo. No contexto do serviço de urgência, foi desenvolvida uma revisão integrativa da literatura intitulada “Cuidados de Enfermagem à Pessoa com Insuficiência Renal Crónica no Serviço de Urgência – Revisão Integrativa da Literatura”, tendo surgido a oportunidade de participar no 1º Congresso Internacional de Enfermagem em Doente Crítico organizado pela Sociedade Portuguesa de Enfermagem em Doente Crítico, com a apresentação do mesmo em forma de póster, através de uma comunicação livre, em novembro de 2024. O resumo foi posteriormente publicado em formato de e-book. Para além disso, foi realizada uma sessão de formação onde foram dados a conhecer os resultados da revisão integrativa da literatura à equipa de enfermagem. Neste contexto, foi criado um procedimento para a manipulação do cateter venoso central de hemodiálise e foi realizado um vídeo com a demonstração. Tanto o procedimento, como o vídeo, foram iniciativas pioneiras na criação de um espaço virtual no serviço, destinado à consulta da equipa de enfermagem. No contexto de cuidados intensivos, foi realizado um artigo de revisão intitulado “Risco de Infeção associado a Cateter Venoso Central e a Cateter de Hemodiálise na Pessoa em Situação Crítica - Scoping Review”, estando este artigo num processo de revisão por pares para submissão a uma revista científica. Para além disso, foi elaborada uma carta ao editor, que foi submetida a uma revista de quartil 1. No entanto, a mesma foi rejeitada pelo conselho editorial. Concluído este percurso, considera-se que as competências desenvolvidas no âmbito da área de Enfermagem Médico-Cirúrgica na área de enfermagem à pessoa em situação crítica proporcionaram recursos fundamentais para a prestação de cuidados de enfermagem especializados, sustentados na reflexão crítica e na melhor evidência científica.
This report falls within the scope of the curricular unit – Final Internship and Report, of the 17th Master's Course in Nursing with Specialization in Medical-Surgical Nursing, in the area of Nursing for People in Critical Situations, at the Escola de Enfermagem (Porto) at the Universidade Católica Portuguesa. The internship was carried out in two different contexts, taking place primarily in an emergency service and, later, in an intensive care service, both in central hospitals in the northern region of the country. The main objective of this report is the description and critical-reflective analysis of the learning process, with the development and integration of knowledge in the provision of nursing care to people in critical situations. For its preparation, a descriptive and reflective methodology was adopted, supported by a careful bibliographic review. The structure of this report is divided into three main parts. The first corresponds to the Introduction, in which a general framework of the report and the internship was provided, the justification of the choices made, and the presentation of the objectives outlined for the report. The second part is dedicated to the description of the internship contexts and the Skills in the Specialized Care of Critical Ill Patient and/or with Chronic Renal Insufficiency, covering the description and critical-reflective analysis of the activities carried out throughout the training course. Finally, the Conclusion presents a global synthesis, with a cross-sectional analysis of the contributions, learning acquired, and difficulties faced during the internship. The contributions in each internship context corresponded to the identified improvement opportunities and the defined learning objectives, favoring the consolidation of skills and continuous improvement. In the context of the emergency service, an integrative review of the literature entitled “Nursing Care for People with Chronic Renal Failure in the Emergency Service – Integrative Literature Review” was developed, giving rise to the opportunity to participate in the 1st International Congress of Nursing in Patients Critical organized by the Portuguese Society of Critically Ill Nursing, with its presentation in the form of a poster, through free communication, in November 2024. The abstract was later published in e-book format. In addition, a training session was held where the results of the integrative literature review were made known to the nursing team. In this context, a procedure was created for manipulating the hemodialysis central venous catheter and a video was made demonstrating it. Both the procedure and the video were pioneering initiatives in creating a virtual space in the service, intended for consultation by the nursing team. In the context of intensive care, a review article was carried out entitled “Risk of Infection associated with Central Venous Catheters and Hemodialysis Catheters in Critically Situated People - Scoping Review”, with this article undergoing a peer review process for submission to a scientific journal. In addition, a letter to the editor was prepared and submitted to a quartile 1 magazine. However, it was rejected by the editorial board. Having completed this journey, I consider that the skills developed in the area of Medical Surgical Nursing have provided me with fundamental resources for providing specialized nursing care, supported by critical reflection and the best scientific evidence.
This report falls within the scope of the curricular unit – Final Internship and Report, of the 17th Master's Course in Nursing with Specialization in Medical-Surgical Nursing, in the area of Nursing for People in Critical Situations, at the Escola de Enfermagem (Porto) at the Universidade Católica Portuguesa. The internship was carried out in two different contexts, taking place primarily in an emergency service and, later, in an intensive care service, both in central hospitals in the northern region of the country. The main objective of this report is the description and critical-reflective analysis of the learning process, with the development and integration of knowledge in the provision of nursing care to people in critical situations. For its preparation, a descriptive and reflective methodology was adopted, supported by a careful bibliographic review. The structure of this report is divided into three main parts. The first corresponds to the Introduction, in which a general framework of the report and the internship was provided, the justification of the choices made, and the presentation of the objectives outlined for the report. The second part is dedicated to the description of the internship contexts and the Skills in the Specialized Care of Critical Ill Patient and/or with Chronic Renal Insufficiency, covering the description and critical-reflective analysis of the activities carried out throughout the training course. Finally, the Conclusion presents a global synthesis, with a cross-sectional analysis of the contributions, learning acquired, and difficulties faced during the internship. The contributions in each internship context corresponded to the identified improvement opportunities and the defined learning objectives, favoring the consolidation of skills and continuous improvement. In the context of the emergency service, an integrative review of the literature entitled “Nursing Care for People with Chronic Renal Failure in the Emergency Service – Integrative Literature Review” was developed, giving rise to the opportunity to participate in the 1st International Congress of Nursing in Patients Critical organized by the Portuguese Society of Critically Ill Nursing, with its presentation in the form of a poster, through free communication, in November 2024. The abstract was later published in e-book format. In addition, a training session was held where the results of the integrative literature review were made known to the nursing team. In this context, a procedure was created for manipulating the hemodialysis central venous catheter and a video was made demonstrating it. Both the procedure and the video were pioneering initiatives in creating a virtual space in the service, intended for consultation by the nursing team. In the context of intensive care, a review article was carried out entitled “Risk of Infection associated with Central Venous Catheters and Hemodialysis Catheters in Critically Situated People - Scoping Review”, with this article undergoing a peer review process for submission to a scientific journal. In addition, a letter to the editor was prepared and submitted to a quartile 1 magazine. However, it was rejected by the editorial board. Having completed this journey, I consider that the skills developed in the area of Medical Surgical Nursing have provided me with fundamental resources for providing specialized nursing care, supported by critical reflection and the best scientific evidence.
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Enfermagem Enfermeiro especialista Insuficiência renal crónica Situação crítica Chronic renal failure Critical situation Nursing care Specialist nurse
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