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Fatores de stresse associados ao desmame ventilatório na pessoa adulta em unidade de cuidados intensivos
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| 3.89 MB | Adobe PDF |
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Abstract(s)
O presente relatório de estágio surge no âmbito do “Mestrado de Enfermagem na área de Especialização de Enfermagem Médico – Cirúrgica pessoa em situação crítica” com o objetivo de descrever e analisar de modo crítico e reflexivo o desenvolvimento e aquisição das competências comuns e específicas para obtenção do título de enfermeira especialista, bem como de todo o percurso académico e científico para obtenção de grau de mestre. No primeiro capítulo será apresentado uma scoping review sobre os fatores de stresse associados ao desmame ventilatório na pessoa adulta em unidade de cuidados intensivos. Os principais fatores de stresse associados ao desmame ventilatório identificados foram: presença do tubo orotraqueal, alteração da comunicação, falta de informação, aspiração de secreções, alteração da mobilidade, ausência dos familiares, momento da extubação, cuidados de higiene, alteração da visão, equipa de enfermagem e alteração da modalidade ventilatória. No segundo capítulo serão apresentados os contextos de estágio – serviço de urgência, unidade de cuidados intensivos e viatura médica de emergência e reanimação – onde foi permitido o desenvolvimento das competências. No terceiro capítulo verifica-se o processo reflexivo, bem como as atividades realizadas, que permitiram atingir as competências comuns e específicas do enfermeiro do enfermeiro especialista em “Enfermagem Médico-Cirúrgica na área de Enfermagem à pessoa em situação crítica”, através do percurso académico e profissional. Destaco para este capítulo a realização de formação em serviço “Abordagem paragem cardiorrespiratória e via aérea” bem como a elaboração de um documento de suporte bibliográfico na “Administração de fármacos via subcutânea” que permitiu mobilizar conhecimentos previamente adquiridos e incluí-los na prestação de cuidados com vista na melhoria contínua; e ainda a participação na formação profissional de “Lesão Renal Aguda em Cuidados Intensivos”, de modo desenvolver autoconhecimento e suportar a prática clínica em evidência científica. No final do percurso considero que consegui atingir o desenvolvimento das competências propostas. Pude ainda verificar que o desenvolvimento das competências como enfermeiro especialista e mestre, bem como todas as experiências vividas, tiveram um grande impacto na forma de me encarar, encarar a profissão, e os outros enquanto pessoas.
This report arises within the scope of the master’s degree in medical – surgical nursing in specialization in person in critical situation, with the objective of describing and analyzing in a critical and reflexive way the development and acquisition of common and specific competencies for obtaining the title of specialized nurse, as well as the entire academic and scientific path to obtain a master’s degree. The first chapter will present a scoping review on the stress factors associated to weaning from mechanical ventilation in adult person in the intensive care unit. The main stress factors associated with weaning from mechanical ventilation identified were: presence of orotracheal tube, altered communication, lack of information, nursing team, hygiene care, aspiration of secretions, absence of family members, moment of extubation and change in the ventilatory modality, altered mobility and vision. The second chapter will be presented the places where the development of skills was allowed – emergency service, intensive care unit and emergency medical vehicle and resuscitation. In the third chapter, the reflective process is then verified, as well as the activities carried out, that allowed to achieve the common and specific competencies of the specialized nurse in person in critical situation, through the academic and professional path. I highlight for this chapter the realization of in-service training “Cardiorespiratory arrest and airway approach” as well as a bibliographic support document in the area of “administration of drugs subcutaneously” that allowed me to mobilize previously acquired knowledge and include them in the provision of care with to continuous improvement; participation in the professional training of “Acute kidney injury in intensive care”, in order to develop self knowledge and support clinical practice in scientific evidence. At the end of the course, I believe that I managed to achieve the development of the proposed skills. I was also able to verify that the development of the competencies as a specialized nurse and master, as well as all the experiences lived, had a great impact on the way I look at me, face the profession and face others as people.
This report arises within the scope of the master’s degree in medical – surgical nursing in specialization in person in critical situation, with the objective of describing and analyzing in a critical and reflexive way the development and acquisition of common and specific competencies for obtaining the title of specialized nurse, as well as the entire academic and scientific path to obtain a master’s degree. The first chapter will present a scoping review on the stress factors associated to weaning from mechanical ventilation in adult person in the intensive care unit. The main stress factors associated with weaning from mechanical ventilation identified were: presence of orotracheal tube, altered communication, lack of information, nursing team, hygiene care, aspiration of secretions, absence of family members, moment of extubation and change in the ventilatory modality, altered mobility and vision. The second chapter will be presented the places where the development of skills was allowed – emergency service, intensive care unit and emergency medical vehicle and resuscitation. In the third chapter, the reflective process is then verified, as well as the activities carried out, that allowed to achieve the common and specific competencies of the specialized nurse in person in critical situation, through the academic and professional path. I highlight for this chapter the realization of in-service training “Cardiorespiratory arrest and airway approach” as well as a bibliographic support document in the area of “administration of drugs subcutaneously” that allowed me to mobilize previously acquired knowledge and include them in the provision of care with to continuous improvement; participation in the professional training of “Acute kidney injury in intensive care”, in order to develop self knowledge and support clinical practice in scientific evidence. At the end of the course, I believe that I managed to achieve the development of the proposed skills. I was also able to verify that the development of the competencies as a specialized nurse and master, as well as all the experiences lived, had a great impact on the way I look at me, face the profession and face others as people.
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Keywords
Desmame ventilatório Enfermeiro especialista Fator de stresse Pessoa em situação crítica Unidade de cuidados intensivos Ventilator weaning Specialized nurse Stress factor Critical patient Intensive care units