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No âmbito do Mestrado em Enfermagem, com Especialização em Enfermagem Médico-Cirúrgica, na área de Enfermagem à Pessoa em Situação Crítica da Universidade Católica Portuguesa – Instituto Ciências da Saúde (Porto), surge o presente relatório. Este reflete criticamente acerca das competências adquiridas, essencialmente nos estágios realizados no âmbito da Unidade Curricular do 2.º ano do Curso - “Estágio Final e Relatório”, em contexto de Serviço de Medicina Intensiva Monovalente e em Serviço de Urgência Polivalente, no período de 5 de setembro a 17 de dezembro de 2022, tendo como ponto de partida as competências desenvolvidas no estágio do 1º ano do Curso, realizado num Serviço de Medicina Intensiva Polivalente. O trabalho encontra-se organizado de acordo com as competências comuns do Enfermeiro Especialista e as competências específicas na área mencionada, segundo a Ordem dos Enfermeiros. Na melhoria contínua foram desenvolvidos trabalhos, como o desenvolvimento de uma revisão da literatura acerca da Avaliação do risco de desenvolver Úlcera Por Pressão através da Escala de Braden, da Escala de Cubbin & Jackson e da Escala revista de Cubbin & Jackson em doentes internados em UCI; um trabalho sobre a Avaliação da Carga de Trabalho em Enfermagem através do Therapeutic Intervention Scoring System (TISS-28) e do Nursing Activities Score (NAS); um trabalho sobre a Violência face ao Profissional de Saúde em Serviço de Urgência e outro sobre a Comunicação com o Doente em Serviço de Urgência. No Cuidado à Pessoa em Situação Crítica e da família/cuidador, foram garantidos os cuidados de forma pronta e antecipatória de processos de instabilidade, percecionando a complexidade dos cuidados exigidos, através da mobilização de conhecimentos. Foi perentória a correta envolvência da família/cuidador, permitindo o estabelecimento de uma relação terapêutica. Na Resposta em Situações de Emergência e Exceção é demonstrada a proatividade, estabelecendo as prioridades necessárias a cada caso. A Intervenção na Prevenção e Controlo da Infeção perante a Pessoa em Situação Crítica é fundamental e aporta ganhos significativos para o doente. Desta forma, foram discutidas e analisadas as necessidades a este nível em cada serviço, refletindo sobre as estratégias a adotar para a prevenção e controlo da infeção, revelando a importância do papel do Enfermeiro Especialista. A aquisição do grau de Mestre em Enfermagem, com especialização em Enfermagem Médico-Cirúrgica, na área de Enfermagem à Pessoa em Situação Crítica compreende uma prática de excelência, fruto da aquisição do saber teórico e prático, baseado na mais recente evidência científica. Foi sempre tida consciência da complexidade das realidades de cuidados, colaborando ativamente nos mesmos e em busca constante pela melhoria contínua. Por conseguinte, foram sendo adquiridas as competências específicas inerentes ao papel do Enfermeiro Especialista.
This report is a part of the Master's Course in Nursing with Medical-Surgical Nursing Specialization, in the Nursing for Critically Ill Patients area at the Universidade Católica Portuguesa - Institute of Health Sciences (Porto). The presented narrative reflects critically on the skills acquired, mainly in the internships carried out within the scope of the 2nd year of the Course "Final Internship and Report", in a Monovalent Intensive Care Unit and in a Multipurpose Emergency Service. It took place between September 5 and December 17, 2022, taking as a starting point the skills developed in the internship of the 1st year of the Course carried out in a Multipurpose Intensive Care Unit. This study is organized in accordance with the specialized nurse common skills and the specialized nurse specific skills in the mentioned area of the Ordem dos Enfermeiros. In what continuous improvement is concerned, studies were developed such as the literature review development on the Assessment of the risk of developing Pressure Ulcer through the Braden Scale, Cubbin & Jackson Scale and the revised Cubbin & Jackson Scale in ICU patients; a paper on Nursing workload assessment using the Therapeutic Intervention Scoring System (TISS-28) and the Nursing Activities Score (NAS); a paper about Violence towards the health professional in the Emergency Service and another on Communication with the patient in the Emergency Service. In the Care of Critically Ill Patients and their families/caregivers, care was ensured in a prompt and anticipatory manner of instability processes, by understanding the complexity of care required, through knowledge mobilization. The family/caregiver correct involvement was peremptory, allowing the establishment of a therapeutic relationship. Regarding the Response in Situations of Emergency and Exception, proactivity is demonstrated, establishing the necessary priorities for each case. Intervention in Prevention and Control of Infection in Critically Ill Patients is fundamental and it brings significant gains for the patient. Thus, the needs at this level in each service were discussed and analysed, reflecting on the strategies to be adopted for infection prevention and control, revealing the Specialized Nurse important role. The acquisition of the Master's degree in Medical-Surgical Nursing for Critically ill Patients comprises a practice of excellence, the result of theoretical acquisition and practical knowledge based on the latest scientific evidence. I have always been aware of the care reality complexity, actively collaborating in care and in constant search for continuous improvement. Therefore, the specific skills inherent to the role of a specialized nurse were acquired.
This report is a part of the Master's Course in Nursing with Medical-Surgical Nursing Specialization, in the Nursing for Critically Ill Patients area at the Universidade Católica Portuguesa - Institute of Health Sciences (Porto). The presented narrative reflects critically on the skills acquired, mainly in the internships carried out within the scope of the 2nd year of the Course "Final Internship and Report", in a Monovalent Intensive Care Unit and in a Multipurpose Emergency Service. It took place between September 5 and December 17, 2022, taking as a starting point the skills developed in the internship of the 1st year of the Course carried out in a Multipurpose Intensive Care Unit. This study is organized in accordance with the specialized nurse common skills and the specialized nurse specific skills in the mentioned area of the Ordem dos Enfermeiros. In what continuous improvement is concerned, studies were developed such as the literature review development on the Assessment of the risk of developing Pressure Ulcer through the Braden Scale, Cubbin & Jackson Scale and the revised Cubbin & Jackson Scale in ICU patients; a paper on Nursing workload assessment using the Therapeutic Intervention Scoring System (TISS-28) and the Nursing Activities Score (NAS); a paper about Violence towards the health professional in the Emergency Service and another on Communication with the patient in the Emergency Service. In the Care of Critically Ill Patients and their families/caregivers, care was ensured in a prompt and anticipatory manner of instability processes, by understanding the complexity of care required, through knowledge mobilization. The family/caregiver correct involvement was peremptory, allowing the establishment of a therapeutic relationship. Regarding the Response in Situations of Emergency and Exception, proactivity is demonstrated, establishing the necessary priorities for each case. Intervention in Prevention and Control of Infection in Critically Ill Patients is fundamental and it brings significant gains for the patient. Thus, the needs at this level in each service were discussed and analysed, reflecting on the strategies to be adopted for infection prevention and control, revealing the Specialized Nurse important role. The acquisition of the Master's degree in Medical-Surgical Nursing for Critically ill Patients comprises a practice of excellence, the result of theoretical acquisition and practical knowledge based on the latest scientific evidence. I have always been aware of the care reality complexity, actively collaborating in care and in constant search for continuous improvement. Therefore, the specific skills inherent to the role of a specialized nurse were acquired.
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Pessoa em situação crítica Úlcera por pressão Carga de trabalho em enfermagem Violência Comunicação Critically ill patient Pressure ulcer Nursing workload Violence Communication