Desenvolvimento de competências no cuidado à pessoa em situação crítica

Abstract

This report is part of the discipline "Final Internship and Report", as part of the master’s degree in nursing in the area of Specialization in Medical-Surgical Nursing, in the area of Nursing for Critically Persons, of the Institute of Health Sciences (Porto), of Universidade Católica Portuguesa. The clinical practices described in this report took place at a Multipurpose Emergency Department and at a Local Unit Program for Infection Prevention and Control and Antimicrobial Resistance (LU-PIPCAR) of two hospital centers in Porto, from September 5 to December 17, 2022. A brief reference is made to the internship carried out during the 1st year of the Course in a Polyvalent Intensive Care Unit. The work is organized according to the common and specific competencies recommended by the Portuguese Nurses' Association, and its main purpose is to demonstrate the development of specialized skills in the mentioned area and sub-area. The 1st year internship at Polyvalent Intensive Care Unit focuses on the particularities of the assistance of the critically persons in a succinct way, in the various dimensions of care, with special focus on care management. A work instruction on blood culture collection was elaborated as a contribution to the improvement of care. The internship of the 2nd year of the discipline, in the Multipurpose Emergency Department context, in the assistance of the critically persons in the context of Urgency and Emergency, the nurse's role in Manchester Triage and the importance of communication with the patient was analyzed, as well as the particularities related to the activation of the various green routes. It was important to develop specific skills in caring for the critically persons in the emergency room (ER) to quickly and safely respond to the emerging situation. The contributions to the improvement of care were directed to the ER, consisting in the development of a list of Drugs used in the ER in the form of a Table of Dilutions and Incompatibility and a proposal for a work instruction on the approach to the severely burned patient in the ER. In the internship in the context of LU-PIPCAR, the role of the specialist nurse in the prevention and control of healthcare-associated infections was analyzed in various aspects, including epidemiological surveillance, audits, consulting in specific cases regarding isolation standards and articulation with various services. A pamphlet about the vaccination campaign against COVID-19 was prepared with the objective of raising awareness about vaccination and contributing to the improvement of care. As a learning result of this journey, the report highlights the development of common competencies in the areas of care management; continuous quality improvement; development of professional learning; and professional, ethical and legal responsibility. With a greater opportunity to develop competencies in the field of professional learning, where the specific competencies of the nurse specialist in medical-surgical nursing are integrated, caring for the person, family/caregiver experiencing complex processes of critical illness and/or organ failure, the maximization of intervention in infection prevention and control, and the dynamization of the response in situations of emergency, exception, and catastrophe.

Date of Award	29 Jun 2023
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Irene Oliveira (Supervisor)