Relatório de prática clínica

Abstract

This report bases the learning process that favours the development of skills for specialist nurse in medical-surgery specialty nursing, through reflective practice. The cross-theme developed in this context was relationed with the provision of specialized care to the medium and high risk patient and family, specially the nephrological patient. The interest in approaching this thematic, came from a critic reflection about the personal and professional development as a nurse in a haemodialysis service. The renal disease can be associated to a acute injury, where the nurse care has its focus in caring for the patient in acute situation and cooperates when the kidney injury presents itself as acute sintomatology. The specialist nurse has its focus in healing care aimed at preserving the life of the patient. In chronic renal disease, accompanying the patient and its family and promoting self-care it’s the aim of the nurse’s attention. Depending in the way the kidney disease settles, the patient may need immediate care that are aimed at preserving the life, as occurs in acute renal disease. The different stage modules allowed to accompany the problematic in each reality, identify needs to intervene and suggest changes that contribute to the improving of care. In the Medical Emergency Unit, were approached the needs of the family from the nursing point of view, was elaborated a checklist in the haemodialysis procedures, was reviewed the heparinization standard for central haemodialysis catheter and was proposed a change to the continuous dialysis modalities register sheet. In the Operating Room, was deepened the theme relationed with the surgical patient safety, was elaborated a nursing discharge/transfer sheet for procedures related with dialysis vascular accesses and was elaborated a checklist for stock control and expiration dates for the OR pharmacy. For last, in the Emergency Service, there was cooperation with the study in patient accompanying satisfaction evaluation; it was proposed a questionnaire to evaluate the attendance user satisfaction and was elaborated a standard procedure rule for the use of central catheter as vascular access in renal patients. This route allowed the development of skills in the areas of managed care, training or research. The main contributors point to the improvement of care, continuity between different levels of health and the possibility of evaluating the quality of nurse care through surveys of user satisfaction and family.

Date of Award	Mar 2011
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Patrícia Pontífice-Sousa (Supervisor)