Um cuidar especializado da pessoa em situação crítica e/ou com insuficiência renal crónica

Abstract

This report falls within the scope of the curricular unit – Final Internship and Report, of the 17th Master's Course in Nursing with Specialization in Medical-Surgical Nursing, in the area of Nursing for People in Critical Situations, at the Escola de Enfermagem (Porto) at the Universidade Católica Portuguesa. The internship was carried out in two different contexts, taking place primarily in an emergency service and, later, in an intensive care service, both in central hospitals in the northern region of the country. The main objective of this report is the description and critical-reflective analysis of the learning process, with the development and integration of knowledge in the provision of nursing care to people in critical situations. For its preparation, a descriptive and reflective methodology was adopted, supported by a careful bibliographic review. The structure of this report is divided into three main parts. The first corresponds to the Introduction, in which a general framework of the report and the internship was provided, the justification of the choices made, and the presentation of the objectives outlined for the report. The second part is dedicated to the description of the internship contexts and the Skills in the Specialized Care of Critical Ill Patient and/or with Chronic Renal Insufficiency, covering the description and critical-reflective analysis of the activities carried out throughout the training course. Finally, the Conclusion presents a global synthesis, with a cross-sectional analysis of the contributions, learning acquired, and difficulties faced during the internship. The contributions in each internship context corresponded to the identified improvement opportunities and the defined learning objectives, favoring the consolidation of skills and continuous improvement. In the context of the emergency service, an integrative review of the literature entitled “Nursing Care for People with Chronic Renal Failure in the Emergency Service – Integrative Literature Review” was developed, giving rise to the opportunity to participate in the 1st International Congress of Nursing in Patients Critical organized by the Portuguese Society of Critically Ill Nursing, with its presentation in the form of a poster, through free communication, in November 2024. The abstract was later published in e-book format. In addition, a training session was held where the results of the integrative literature review were made known to the nursing team. In this context, a procedure was created for manipulating the hemodialysis central venous catheter and a video was made demonstrating it. Both the procedure and the video were pioneering initiatives in creating a virtual space in the service, intended for consultation by the nursing team. In the context of intensive care, a review article was carried out entitled “Risk of Infection associated with Central Venous Catheters and Hemodialysis Catheters in Critically Situated People - Scoping Review”, with this article undergoing a peer review process for submission to a scientific journal. In addition, a letter to the editor was prepared and submitted to a quartile 1 magazine. However, it was rejected by the editorial board. Having completed this journey, I consider that the skills developed in the area of Medical Surgical Nursing have provided me with fundamental resources for providing specialized nursing care, supported by critical reflection and the best scientific evidence.

Date of Award	29 May 2025
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Ana Carolina da Rocha Monteiro (Supervisor)