Assistência à pessoa em situação crítica

: desenvolvimento de competências especializadas

Abstract

As part of the curriculum plan of Nursing Care Master's Degree: Medical-Surgical Care - in the Nursing for Critically Ill Patient of Porto Universidade Católica Portuguesa, two placements were completed within the Final Internship and Report". This document is a reflection of those placements. The internship took place in an Intensive Care Unit of Cardiothoracic (UCI-CT) and an Intensive Care Medicine Service (SMI) from September 5, 2022 and December 17, 2022. In the first chapter are mentioned the skills acquired during the placement in Emergency Care as part of the Curriculum Unit “The person in Critical Condition and Family: Monitoring and Clinical Decision" of the first year. It was enhance knowledge about the trauma rooms organization, having carried out a work instruction for the systematization of care and care for the patient victim of trauma. Afterwards, it is framed the activities carried out during the curricular unit "Final Traineeship and Report" based on the specific objectives previously defined, integrating them into the common competencies of the Specialist Nurse. In ethical and legal professional practice, reflected on ethical decision-making process, respecting the beliefs and values of the sick patient; the ethical dilemmas, particularly in the suspension of ventilatory and hemodynamic support, perceiving the role of the Specialist Nurse; communication with the family regarding to breaking bad news, applying communication techniques precisely the SPIKES protocol. In quality improvement, transmission of information security and its culture were analyzed. In management care, the method of distribution of work, the leadership style, team management and decision-making have been explored. In professional learning, the updating of infection control standards, the surveillance of the Nursing for Critically Ill Patient and the application of sedation, analgesia and evaluation of delirium protocols was especially relevant. It was identified in both contexts an opportunity for improvement in the context of the prevention and management of delirium in the person hospitalized in the ICU, having carried out in-depth research in its own chapter, and made two proposals for improvement: a quick consultation guide in the evaluation and prevention of delirium, which aimed to sensitize the multidisciplinary team to the importance of evaluation, prevention. Noteworthy is the acquisition of specialized skills in the field of infection prevention and control, and mobilization of knowledge in the search for a practice based on the latest scientific evidence.

Date of Award	12 Sept 2023
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Irene Oliveira (Supervisor)