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Este relatório surge no âmbito da Unidade Curricular “Estágio Final e Relatório”, inserida no plano do Curso de Mestrado em Enfermagem com Especialização em Enfermagem Médico-Cirúrgica e pretende refletir o percurso de aprendizagem e de aquisição de competências enquanto Enfermeiro Especialista. Este caminho decorreu no contacto com contextos da prática clínica, em ambiente de Serviço de Urgência e Cuidados Intensivos, focando o cuidado à pessoa em situação crítica. Com este documento procurou-se apresentar objetivos planeados e concretizados, descrever atividades desenvolvidas e competências adquiridas neste contexto, utilizando uma visão crítico-reflexiva para a demonstração do caminho percorrido. Para a sua elaboração, partiu-se de evidência atual e com qualidade para fundamentação e tomada de decisão e utilizou-se uma metodologia expositiva, descritiva e reflexiva. Os objetivos definidos para a Unidade Curricular, o projeto e portefólio de estágio e os trabalhos elaborados no seu decorrer serviram de alicerce à sua construção. Este relatório abrange uma reflexão sobre o processo de aprendizagem e aquisição de competências prévios, a contextualização dos locais da prática clínica, o processo de aquisição de competências na área de especialização e uma análise global do percurso de aprendizagem e principais implicações para a prática profissional e crescimento pessoal e académico.
Através do desenvolvimento de uma revisão da literatura e intervenção na equipa do Serviço de Urgência sobre os cuidados e nova evidência na manutenção de cateteres venosos periféricos, foram promovidas estratégias para o controlo de infeção e resistência a antimicrobianos, demonstrando a sua relação com a segurança do doente. A recolha e análise de dados relativos a esta manutenção em Cuidados Intensivos facilitou a reflexão e acompanhamento do seu curso ao longo do internamento. Com a apresentação de propostas de atualização a um protocolo de insulinoterapia e sugestão de um algoritmo de atuação em Cuidados Intensivos contribuiu-se para a melhoria da qualidade de cuidados, partindo de uma necessidade identificada. Demonstrou-se a importância do Enfermeiro Especialista na gestão de recursos e cuidados e a forma como pode contribuir para que estes tenham mais qualidade, com menos custos associados. A importância do papel do enfermeiro no planeamento da intervenção pela equipa multidisciplinar é relacionada com a prestação de cuidados mais completos, eficazes e seguros. A prática profissional com enfoque na ética, deontologia, comunicação e relação terapêutica é igualmente refletida neste trabalho.
O principal contributo neste crescimento enquanto Enfermeiro Especialista remete à capacidade de reflexão e gestão na prestação de cuidados e o desempenho de ações fundamentadas em evidência atual e de qualidade. Assim se compreende a importância da investigação para a evolução dos cuidados de enfermagem e o desenvolvimento da profissão construída por enfermeiros mais formados e atualizados.
This report has been done in the scope of the curricular unit “Final Internship and Report”, as part of the Master's Degree in Nursing with Specialization in Medical-Surgical Nursing, and aims to reflect on a Specialist Nurse's learning journey and skill acquisition. The journey was done within the contexts of a clinic, an Emergency Department and an Intensive Care environment, focusing on care for people in critical situations. This document sought to present planned and accomplished goals, as well as describe activities developed and skills acquired within this context, using a critical-reflexive approach to demonstrate the path taken. It was based on current and high-quality evidence for reasoning and decision making and used an expository, descriptive and reflective methodology. The goals defined for the Curricular Unit, the internship portfolio and project, as well as the works developed, served as a foundation for its development. This report covers a reflection on the learning process and previous acquisition of skills, the contextualization of clinical practices, the process of acquiring skills in the area of specialization, and a global analysis of the learning journey and main implications for the professional practice, as well as personal and academic growth. Strategies for the control of infection and resistance to antimicrobials were furthered through the development of a literature review and intervention in the emergency department team regarding care and new evidence on the maintenance of peripheral venous catheters, demonstrating its correlation with patient safety. The collection and analysis of data related to this maintenance in intensive care facilitated the reflection and monitoring of its course throughout hospitalization. The presentation of proposals to update an insulin therapy protocol and the suggestion of an algorithm to be used in intensive care contributed to the improvement of the quality of care, based on an identified need. The importance of the Specialist Nurse in the management of resources and care was shown, as was the way the Specialist Nurse can contribute with more quality and less associated costs. The importance of the nurse's role in planning the intervention of the multidisciplinary team is related to the provision of more complete, effective and safer care. The professional practice with a focus on ethics, deontology, communication and therapeutic relationship has also been reflected in this work. The main contribution to this growth as a Specialist Nurse refers to the capacity for reflection and management in the provision of care and actions based on current and high-quality evidence. Consequently, the importance of research for the evolution of nursing care and the development of the profession forged by more trained and updated nurses is recognised
This report has been done in the scope of the curricular unit “Final Internship and Report”, as part of the Master's Degree in Nursing with Specialization in Medical-Surgical Nursing, and aims to reflect on a Specialist Nurse's learning journey and skill acquisition. The journey was done within the contexts of a clinic, an Emergency Department and an Intensive Care environment, focusing on care for people in critical situations. This document sought to present planned and accomplished goals, as well as describe activities developed and skills acquired within this context, using a critical-reflexive approach to demonstrate the path taken. It was based on current and high-quality evidence for reasoning and decision making and used an expository, descriptive and reflective methodology. The goals defined for the Curricular Unit, the internship portfolio and project, as well as the works developed, served as a foundation for its development. This report covers a reflection on the learning process and previous acquisition of skills, the contextualization of clinical practices, the process of acquiring skills in the area of specialization, and a global analysis of the learning journey and main implications for the professional practice, as well as personal and academic growth. Strategies for the control of infection and resistance to antimicrobials were furthered through the development of a literature review and intervention in the emergency department team regarding care and new evidence on the maintenance of peripheral venous catheters, demonstrating its correlation with patient safety. The collection and analysis of data related to this maintenance in intensive care facilitated the reflection and monitoring of its course throughout hospitalization. The presentation of proposals to update an insulin therapy protocol and the suggestion of an algorithm to be used in intensive care contributed to the improvement of the quality of care, based on an identified need. The importance of the Specialist Nurse in the management of resources and care was shown, as was the way the Specialist Nurse can contribute with more quality and less associated costs. The importance of the nurse's role in planning the intervention of the multidisciplinary team is related to the provision of more complete, effective and safer care. The professional practice with a focus on ethics, deontology, communication and therapeutic relationship has also been reflected in this work. The main contribution to this growth as a Specialist Nurse refers to the capacity for reflection and management in the provision of care and actions based on current and high-quality evidence. Consequently, the importance of research for the evolution of nursing care and the development of the profession forged by more trained and updated nurses is recognised
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Enfermagem especializada Prática baseada na evidência Qualidade de cuidados Doente crítico Specialised nursing Evidence-based practice Quality of care Critical patient