Rumo à prestação do cuidado seguro

Abstract

This report is part of the Master's Degree in Nursing in the area of Specialization in Medical-Surgical Nursing, in the area of Critical Care, of the Nursing School of Lisbon, Institute of Health Sciences of the Portuguese Catholic University. It results from the development of three internships focused on the care of critically ill patients: Experience I Operating Theatre, Experience II Permanent Attendance Service and the internship carried out at the Cardiothoracic Surgical Intensive Care Unit (optional internship). These internships, which are the focus of this report, took place in the urban area of Lisbon, between June 2nd, 2020 and January 15th, 2021. In a reflective analysis of the care context and within the scope of the promotion of quality and safety of care, the interest in the topic of good clinical practices emerged, specifically regarding its adherence and effects, because nurses do not always do what they know. The way health professionals act is related to the quality of care provided and the patient's satisfaction and benefit. Thus, a multiplicity of factors converge for good practices/evidence¬based practices. In view of the above and in order to base practice on the best scientific evidence, a scoping review of the literature was conducted and the following research question was defined: What factors influence nurses' adherence to good clinical practices? This report aims to describe the activities that were developed and enabled the acquisition of specialized skills in different contexts of clinical practice, using critical and reflective thinking and an attitude of proactivity and permanent questioning of professional practices. Thus, the development of competencies compatible with the level of specialist nurse in Medical Surgical Nursing is an unfinished path that was built throughout this formative journey, which is the subject of this report. In order to provide a faithful and close account of the reality experienced, we characterized not only the activities developed confronted with life transitions, moments of life in which there are high levels of vulnerability and thus, consequently, of health risk. Analysis, but also the rationale inherent to the decision making process. The theoretical framework adopted was Alaf Meleis' transition theory. In nursing practice, the focus will be on the human responses of individuals when they are faced with life transitions, moments of life in which there are high levels of vulnerability and, consequently, of health risk. The critical and reflective analysis about the common and specific competencies, which are described throughout this report, has proven to be constructive and enriching, contributing to my personal and professional growth through the awareness of my abilities as a future specialist nurse as well as the areas that need investment in the future. It is important to mention that I identify the current pandemic situation, manifested by the exhaustion of multidisciplinary teams and increased workload related especially to the control of the pandemic and treatment of patients with clinical diagnosis of SARS Cov2, as a limitation and constraint to the completion of the internships mentioned above.

Date of Award	10 Dec 2021
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Filipa Veludo (Supervisor)