Desenvolvimento de competências especializadas à pessoa em situação crítica

: segurança no cuidar

Abstract

This report is the result of an academic path that was accomplished in the scope of the 13th Master Degree with Specialization in Medical-Surgical Nursing, inserted in the curricular unity “Final Internship and Report”, and after the accomplishment of the internship in two distinct contexts of clinical practice, first in a Multipurpose Intensive Medicine Unit, and lastly in a Cardiac Intensive Care Unit , as a requisition for the attainment of the master degree in this area of specialization. Resorting to a descriptive, analytical, and reflective methodology, sustained by bibliographic research, the drafting of this document has the goal of giving visibility to the acquired and developed skills throughout this path, focused on the caring of the person and family that are experiencing critical illness and/or organ failure processes, and with a main focus in the promotion of safety care practices, aiming for excellence of caring in nursing. This report includes an approach to the developed skills in the 1st year internship of this degree, in a Multipurpose Emergency Room Unit; a brief description of the internship contexts of the aforementioned curricular unit, and the description of the main activities and reflections experienced in clinical practice context, with a critical analysis of the identified problematic situations, and the suggestion and implementation of resolution strategies, as a contribution for the improvement and quality of the care provided. It had as a baseline the fulfillment of the specific goals previously established in the internship project and cross-cutting to both contexts, as it is organized according to the dominions of the common skills of the specialist nurse. The undertaken activities met the detected improvement opportunities, considered pertinent for the contexts at hand, standing out the survey created in the Intensive Medicine Unit with the purpose of evaluating the perception of nursing professionals of that unit when it comes to resort to mechanical restraint measures on the critical patient. Its application allowed a local profiling of the theme that is under analysis and culminated in the creation of a document entitled “The mechanical restraint on the critical patient”, linking the interpretation of the results under the scientific evidence, which allowed the elaboration of a training about the theme at hand. In the Cardiac Intensive Care Unit, regarding the systematization and standardization of the care practice in inserting and maintaining a central venous catheter, it was created a checklist of the correct procedure, that has the goal to introduce this monitoring instrument in the daily activities of this unit, in order to reduce the infection rates associated with the use of this device, and consequentially assure a safety warranty and improvement of quality in the care given. All these interventions were supported and underpinned with the current scientific evidence, and consequential literature reviews performed in scientific data bases, that led to the individual development, the mastery of knowledge to better do it, thus adding to a care practice aiming for excellency and gains in health.

Date of Award	18 Oct 2021
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Amélia Ferreira (Supervisor)