Prevenção do delirium na pessoa em situação critica

: uma intervenção especializada de enfermagem

Abstract

The preparation of this Report arises within the scope of the Nursing Masters Course with Medical-Surgical Nursing Specialization in the area of Nursing for People in Critical Situation, of the Catholic University of Lisbon, which intends to reflect the work undertaken whereby, through a critical and reflective analysis, my intention is to describe the activities carried out and experiences gathered subsidiary to the development, instrumental competences and differentiated theories and to the achievement of the goals set out. The common and specific competences of a nurse specialized in Medical-Surgical Nursing in the area of Nursing for People in Critical Situation developed, as well as those required for a Masters Degree, will be the focus of this report. The locations for the internship chosen were an Accident and Emergency Department (A&E) and Neurocritical Intensive Care Unit of a central hospital inLisbon. Acknowledging the professional experience as a nurse in an intensive care unit, I started this training path convinced that some of the competences requiredal ready had adequate indicators to respond to the care needs of a Person in Critical Situation. Being a current topic and of great relevance due to the consequences that may arise from this clinical situation, I developed my work of investigation under the theme Delirium. For that purpose, I proceeded with an integrative revision of literature. As a result of that revision, it was possible to organize nursing interventions in the identification, prevention and control of delirium incidents and tounder line the importance of the role of a nurse. With this study, it may be concluded that a nurse has a very important role in the prevention of delirium of PSC, with the adoption of measures related with the environment, sleep promotion, therapeutic intervention, cognitive assessment and patient guidance, protocols, family participation, nurse training and patient education. The implementation of this set of measures is more efficient in the reduction of a delirium incident, compared with its isolated use. At the Accident and Emergency Department (A&E), the focus was based on the development of competences in the care provided to a person in an emerging situation, with hemodynamic instability and a risk of organ failure, as well as in the assistance to the family. I could divulge and apply some of the nursing interventions in the prevention of delirium in the critical patient, based on the bibliographic review made. With respect to the intensive care unit, I directed my experience to the area of prevention of secondary lesions of the neurocritical patient, application of sedation and consciousness evaluation scales whereby I make a critical analysis of the several existing tools, of its applicability and restrictions. In this context and considering that it a subject of interest to the nursing team, I followed a training course on the sedation scale, the Richmond Agitation-Sedation Scale. Consequently, this Report aims to demonstrate the development process of competences in a component with scientific evidence, acknowledging the importance of this synergism for the practice of advanced care.

Date of Award	11 Feb 2021
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Manuela Madureira (Supervisor)