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Demora no atendimento intra-hospitalar na cardiopatia isquémica : Via verde coronária
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A educação permanente e o aprimoramento profissional em Enfermagem são indispensáveis para assegurar uma prática segura, eficaz e humanizada. A utilização de evidências científicas na tomada de decisões clínicas fortalece a qualidade dos cuidados prestados, garantindo que as intervenções sejam baseadas em conhecimentos atualizados e rigorosos. A formação especializada é essencial para lidar com as complexidades das áreas de Enfermagem Médico-Cirúrgica e de Cuidados à Pessoa em Estado Crítico, permitindo que os enfermeiros enfrentem os desafios com competência e segurança. Manter o foco no cuidado centrado na pessoa, mesmo em contextos de alta complexidade, é fundamental para preservar a dignidade e atender às necessidades individuais. Além disso, estimular a investigação e a geração de novos saberes contribui para o avanço da enfermagem enquanto ciência, promovendo práticas inovadoras e fundamentadas em evidências. Desse modo, é indispensável investir em formação contínua, na atualização de conhecimentos e na avaliação constante das competências, assegurando uma atuação cada vez mais qualificada e sintonizada com as exigências da pessoa em situação crítica.
Objetivo: Refletir de forma crítica e fundamentada sobre as atividades desenvolvidas durante os estágios clínicos realizados no Serviço de Urgência e na Unidade de Cuidados Intensivos, evidenciando o desenvolvimento de competências técnicas, relacionais e especializadas voltadas para uma prática centrada na pessoa, segura e sustentada pelas melhores evidências científicas disponíveis. Avaliar o tempo de espera no atendimento hospitalar de pacientes com cardiopatia isquémica que deram entrada pela Via Verde Coronária.
Métodos: Este trabalho está dividido em duas partes: a Parte I contempla a contextualização das competências gerais e específicas da enfermagem médico-cirúrgica adquiridas durante os estágios em contexto de urgência e cuidados intensivos, bem como as atividades desempenhadas; já a Parte II corresponde a um estudo de investigação descritivo, transversal e retrospetivo, com abordagem quantitativa intitulado “Tempo de demora no atendimento intra-hospitalar nas Síndromes Coronárias Agudas – Via Verde Coronária”. A amostra, não probabilística, foi composta por indivíduos admitidos no Serviço de Urgência com dor torácica sugestiva de cardiopatia isquémica entre janeiro de 2023 e dezembro de 2024 com ativação da Via Verde Coronária. Os dados foram colhidos por meio da análise documental dos registos clínicos.
Resultados: Os estágios em Serviço de Urgência e Unidade de Cuidados Intensivos possibilitaram o aprofundamento das competências técnicas, relacionais e éticas indispensáveis a uma prática de enfermagem segura e centrada na pessoa, baseada em evidências científicas. As atividades desenvolvidas favoreceram a melhoria da capacidade de intervenção rápida e eficaz, promovendo uma abordagem integral ao doente, com respeito às suas necessidades e valores. A vivência prática destacou a importância das habilidades de comunicação, do trabalho colaborativo e da tomada de decisões clínicas, especialmente em contextos com elevada exigência. A análise dos tempos de resposta evidenciou variações associadas a fatores sociodemográficos (como idade e sexo), variáveis clínicas (gravidade do quadro, doenças associadas) e fatores organizacionais (como gestão de recursos e dinâmica do serviço), o que ressalta a importância de estratégias que melhorem a agilidade e a qualidade do atendimento.
Conclusão: As experiências formativas e investigativas propiciaram o desenvolvimento de competências avançadas na gestão do cuidado a pessoas em estado crítico, na análise de indicadores de qualidade e na tomada de decisões clínicas fundamentadas. Esse processo resultou numa prática de enfermagem mais autónoma, qualificada e voltada para a melhoria contínua dos cuidados em ambientes de alta complexidade. Os dados obtidos no estudo reforçam a importância do tempo na abordagem inicial, no diagnóstico precoce e no tratamento da Síndrome Coronária Aguda, destacando esse fator como um indicador sensível da qualidade dos cuidados prestados em situações de urgência.
Palavras-chave: Enfermagem médico-cirúrgica; Cuidados intensivos; Formação contínua; Prática baseada em evidências; Cardiopatia isquémica; Via verde Coronária.
Abstract Ongoing education and professional development in Nursing are essential to ensure safe, effective, and humanized care practices. The use of scientific evidence in clinical decision-making strengthens the quality of care provided, ensuring that interventions are based on up-to-date and rigorous knowledge. Specialized training is crucial to address the complexities of Medical-Surgical Nursing and Critical Care, enabling nurses to face challenges with competence and confidence. Maintaining a person-centered approach, even in high-complexity settings, is key to preserving dignity and addressing individual needs. Furthermore, encouraging research and the generation of new knowledge contributes to the advancement of nursing as a science, promoting innovative, evidence-based practices. Thus, it is essential to invest in continuous education, knowledge updating, and constant evaluation of competencies to ensure increasingly qualified care aligned with the demands of critically ill patients. Objective: To critically and reflectively analyze the activities carried out during clinical placements in the Emergency Department and Intensive Care Unit, highlighting the development of technical, relational, and specialized skills aimed at a person-centered, safe, and evidence-based nursing practice. Additionally, to assess the in-hospital waiting time for patients with ischemic heart disease admitted through the Coronary Green Pathway. Methods: This work is divided into two parts: Part I includes the contextualization of the general and specific competencies of medical-surgical nursing acquired during the placements in emergency and intensive care settings, as well as the activities performed; Part II presents a descriptive, cross-sectional, and retrospective research study with a quantitative approach, entitled “In-hospital Delay Time in the Care of Acute Coronary Syndromes – Coronary Green Pathway.” The non-probabilistic sample consisted of individuals admitted to the Emergency Department with chest pain suggestive of ischemic heart disease, between January 2023 and December 2024, with activation of the Coronary Green Pathway. Data were collected through the documentary analysis of clinical records. Results:The placements in the Emergency Department and Intensive Care Unit enabled the development of technical, relational, and ethical competencies essential for safe, person-centered, and evidence-based nursing practice. The activities carried out improved the ability to intervene quickly and effectively, promoting a comprehensive approach to the patient, respecting their needs and values. The practical experience highlighted the importance of communication skills, collaborative work, and clinical decision-making, especially in high-demand contexts. The analysis of response times revealed variations related to sociodemographic factors (such as age and sex), clinical variables (severity of the condition, associated diseases), and organizational factors (such as resource management and service dynamics), underlining the need for strategies to enhance the agility and quality of care. Conclusion: The educational and research experiences fostered the development of advanced competencies in critical care management, quality indicator analysis, and evidence-based clinical decision-making. This process resulted in more autonomous and qualified nursing practice focused on the continuous improvement of care in high-complexity settings. The findings reinforce the importance of timely initial assessment, early diagnosis, and treatment of Acute Coronary Syndromes, emphasizing time as a sensitive indicator of the quality of care provided in emergency situations. Keywords: Medical-surgical nursing; Intensive care; Continuing education; Evidence-based practice; Ischemic heart disease; Coronary Green Pathway
Abstract Ongoing education and professional development in Nursing are essential to ensure safe, effective, and humanized care practices. The use of scientific evidence in clinical decision-making strengthens the quality of care provided, ensuring that interventions are based on up-to-date and rigorous knowledge. Specialized training is crucial to address the complexities of Medical-Surgical Nursing and Critical Care, enabling nurses to face challenges with competence and confidence. Maintaining a person-centered approach, even in high-complexity settings, is key to preserving dignity and addressing individual needs. Furthermore, encouraging research and the generation of new knowledge contributes to the advancement of nursing as a science, promoting innovative, evidence-based practices. Thus, it is essential to invest in continuous education, knowledge updating, and constant evaluation of competencies to ensure increasingly qualified care aligned with the demands of critically ill patients. Objective: To critically and reflectively analyze the activities carried out during clinical placements in the Emergency Department and Intensive Care Unit, highlighting the development of technical, relational, and specialized skills aimed at a person-centered, safe, and evidence-based nursing practice. Additionally, to assess the in-hospital waiting time for patients with ischemic heart disease admitted through the Coronary Green Pathway. Methods: This work is divided into two parts: Part I includes the contextualization of the general and specific competencies of medical-surgical nursing acquired during the placements in emergency and intensive care settings, as well as the activities performed; Part II presents a descriptive, cross-sectional, and retrospective research study with a quantitative approach, entitled “In-hospital Delay Time in the Care of Acute Coronary Syndromes – Coronary Green Pathway.” The non-probabilistic sample consisted of individuals admitted to the Emergency Department with chest pain suggestive of ischemic heart disease, between January 2023 and December 2024, with activation of the Coronary Green Pathway. Data were collected through the documentary analysis of clinical records. Results:The placements in the Emergency Department and Intensive Care Unit enabled the development of technical, relational, and ethical competencies essential for safe, person-centered, and evidence-based nursing practice. The activities carried out improved the ability to intervene quickly and effectively, promoting a comprehensive approach to the patient, respecting their needs and values. The practical experience highlighted the importance of communication skills, collaborative work, and clinical decision-making, especially in high-demand contexts. The analysis of response times revealed variations related to sociodemographic factors (such as age and sex), clinical variables (severity of the condition, associated diseases), and organizational factors (such as resource management and service dynamics), underlining the need for strategies to enhance the agility and quality of care. Conclusion: The educational and research experiences fostered the development of advanced competencies in critical care management, quality indicator analysis, and evidence-based clinical decision-making. This process resulted in more autonomous and qualified nursing practice focused on the continuous improvement of care in high-complexity settings. The findings reinforce the importance of timely initial assessment, early diagnosis, and treatment of Acute Coronary Syndromes, emphasizing time as a sensitive indicator of the quality of care provided in emergency situations. Keywords: Medical-surgical nursing; Intensive care; Continuing education; Evidence-based practice; Ischemic heart disease; Coronary Green Pathway
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Atraso no tratamento Competência profissional Enfermagem médico cirúrgica Isquémia do miocárdio Tempo para o tratamento Medical surgical nursing Myocardial ischemia Professional competence Treatment delay Time to treatment
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