Aquisição e desenvolvimento de competências especializadas na abordagem à pessoa em situação crítica

Abstract

This work was written as part of the Final Internship and Report course of the 1st semester of the 2nd year of the 16th Master's Degree in Nursing, specialising in medical-surgical nursing in the area of nursing for people in critical situations, at the School of Nursing (Porto) of the Universidade Católica Portuguesa, in the 2023/2024 academic year. It comes about as part of the internship, firstly in the context of the Cardiothoracic Intensive Care Unit, then in the context of the Multipurpose Intensive Care Medicine Service, taking as a starting point the competences developed in the 1st year of the course, carried out in the Multipurpose Emergency Service. This report includes a contextualisation of the internship sites, as well as an illustration and reflection of the path taken during the internship in both contexts, demonstrating a critical and reasoned reflection on the actions observed and carried out in response to the objectives set out in the individual project, reflecting the acquisition of the competences achieved. In the area of continuous quality improvement, in the context of the Cardiothoracic Intensive Care Unit, a case study was developed, exploring the priority nursing interventions at the time of patient admission, with a view to systematising nursing care, especially with regard to the formulation of diagnoses for the post-operative care of patients undergoing cardiac surgery. In the context of the Multipurpose Intensive Care Medicine Service, in order to standardise nursing practice in the care of patients with cervical collars, a study was drawn up in the form of a proposed protocol for the service, essentially through a theoretical foundation based on scientific evidence on the subject and listed nursing interventions to support clinical practice. Given that the presence of a cervical collar is such a specific area, and could have restricted and limited the bibliographical research carried out previously, the need arose to research the topic of Medical Device Related Pressure Injury in a more comprehensive way, through a literature review, where various preventative measures emerged. With the aim of identifying the needs of the person, family and carers, ensuring early detection, stabilisation, maintenance and recovery in intensive care patients and achieving the objectives defined in the individual internship project, various activities were carried out. It can therefore be said that the contexts provided numerous learning opportunities, such as performing highly complex technical care for people experiencing critical illness and/or organ failure, identifying signs of deterioration in the clinical state of people in critical situations in good time, responding effectively in unexpected situations and developing clinical reasoning, acting and decision-making skills in situations of haemodynamic instability. It can therefore be inferred that this learning process has had implications for professional practice, such as the development of the capacity for reflection and critical evaluation in the holistic approach to the patient and the provision of care based on the best scientific evidence, contributing to research and the development of the profession by carrying out scientific work.

Date of Award	20 Jun 2024
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Irene Oliveira (Supervisor)