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Abstract(s)
Introdução: A enfermagem é uma ciência que está em constante evolução técnica e científica, exigindo ao profissional de enfermagem competências específicas para prestar cuidados de excelência à pessoa, mais concretamente ao doente crítico. Formações específicas e especializadas, colocando em prática o saber “saber”, contribuem para a aquisição de conhecimentos e promovem a participação e o progresso da investigação, permitindo a melhoria e otimização da qualidade de resultados e a segurança do doente, tornando o Enfermeiro autónomo e com capacidade de tomar decisões baseadas na evidência científica e técnica.
Objetivo: Descrever as competências específicas adquiridas durante o estágio, em contexto de Urgência e em Cuidados Intensivos, ao doente crítico; Avaliar se a concentração de oxigénio nasal por alto fluxo reduz a qualidade do reflexo de deglutição aquando da ingestão de alimentos de várias consistências e quais são os fatores adjuvantes.
Métodos: Este trabalho é dividido em dois capítulos. O primeiro capítulo descreve as atividades que foram desenvolvidas durante o ensino clínico, em contexto de Urgência e em contexto de Cuidados Intensivos, em hospitais distintos, com análise crítico-refletiva, permitindo a evolução e melhoria de competências comuns da atividade profissional e, ainda, adquirir progressivamente outras de especialização. O segundo capítulo é um estudo observacional e explicativo, de análise quantitativa e desenvolvido segundo um corte transversal, realizado a 24 doentes a realizar oxigénio nasal por alto fluxo, internados numa unidade de Cuidados Intensivos, num Centro Hospitalar português.
Resultados: Com esta prática profissionais foi possível o desenvolvimento de competências especificas na vertente médico-cirúrgica do Enfermeiro especialista, mais concretamente no domínio da responsabilidade profissional, ética e legal, da gestão dos cuidados, do desenvolvimento das aprendizagens profissionais. Os doentes submetidos ao alto fluxo apresentaram alterações na qualidade de deglutição com fluxos superiores 55L/m, mais ainda quando associados a outros fatores.
Conclusão: Obter uma competência mais especifica a nível de enfermagem solidifica os conhecimentos teóricos e práticos, permitindo uma maior consciencialização profissional e, ao mesmo tempo, a evolução do objeto de estudo, contribuindo para o desenvolvimento da saúde. Desta forma, quando se pretende iniciar a ingestão oral num doente com alto fluxo deve se ter um olhar mais atendo e avaliação a qualidade de deglutição.
Palavras-chave: Doente crítico; enfermagem médico-cirúrgica; oxigénio nasal de alto fluxo; qualidade de deglutição; cuidados intensivos.
Abstract Introduction: Nursing is a science that is constantly evolving technically and scientifically, requiring nurses to have specific skills in order to provide excellent care to the person, more specifically to the critically ill patient. Specific and specialized trainings, putting into practice the "knowing", contribute to the acquisition of knowledge and promote the participation and progress of research, allowing the improvement and optimization of the quality of results and patient safety, making the nurse autonomous and able to make decisions based on scientific and technical evidence. Objective: Describe the specific skills acquired during the internship, in the context of emergency and intensive care, to the critically ill patient; Evaluate whether the concentration of nasal oxygen by high flow reduces the quality of the swallowing reflex when ingesting food of various consistencies and what the adjuvant factors are. Methods: This work is divided into two chapters. The first chapter describes the activities that were developed during clinical teaching, in an emergency and intensive care setting, in different hospitals, with critical-reflective analysis, allowing the evolution and improvement of common competences of professional activity and, also, progressively acquiring others of specialization. The second chapter is an observational and explanatory study, of quantitative analysis and developed according to a cross-sectional approach, carried out with 24 patients on high-flow nasal oxygen, admitted to an intensive care unit, in a Portuguese Hospital Center. Results: With this professional practice, it was possible to develop specific skills in the medical-surgical area of the specialist nurse, specifically in the areas of professional, ethical and legal responsibility, care management and the development of professional learning. Patients who underwent high flow presented alterations in the quality of swallowing with flows above 55L/min, even more so when associated with other factors. Conclusion: Obtaining a more specific competence at nursing level solidifies theoretical and practical knowledge, allowing for greater professional awareness and, at the same time, the evolution of the object of study, contributing to the development of health. In this way, when you want to start oral ingestion in a patient with high flow, you should take a closer look and assess the quality of swallowing. Keywords: Critically ill patient; medical-surgical nursing; high-flow nasal oxygen; swallowing quality; intensive care.
Abstract Introduction: Nursing is a science that is constantly evolving technically and scientifically, requiring nurses to have specific skills in order to provide excellent care to the person, more specifically to the critically ill patient. Specific and specialized trainings, putting into practice the "knowing", contribute to the acquisition of knowledge and promote the participation and progress of research, allowing the improvement and optimization of the quality of results and patient safety, making the nurse autonomous and able to make decisions based on scientific and technical evidence. Objective: Describe the specific skills acquired during the internship, in the context of emergency and intensive care, to the critically ill patient; Evaluate whether the concentration of nasal oxygen by high flow reduces the quality of the swallowing reflex when ingesting food of various consistencies and what the adjuvant factors are. Methods: This work is divided into two chapters. The first chapter describes the activities that were developed during clinical teaching, in an emergency and intensive care setting, in different hospitals, with critical-reflective analysis, allowing the evolution and improvement of common competences of professional activity and, also, progressively acquiring others of specialization. The second chapter is an observational and explanatory study, of quantitative analysis and developed according to a cross-sectional approach, carried out with 24 patients on high-flow nasal oxygen, admitted to an intensive care unit, in a Portuguese Hospital Center. Results: With this professional practice, it was possible to develop specific skills in the medical-surgical area of the specialist nurse, specifically in the areas of professional, ethical and legal responsibility, care management and the development of professional learning. Patients who underwent high flow presented alterations in the quality of swallowing with flows above 55L/min, even more so when associated with other factors. Conclusion: Obtaining a more specific competence at nursing level solidifies theoretical and practical knowledge, allowing for greater professional awareness and, at the same time, the evolution of the object of study, contributing to the development of health. In this way, when you want to start oral ingestion in a patient with high flow, you should take a closer look and assess the quality of swallowing. Keywords: Critically ill patient; medical-surgical nursing; high-flow nasal oxygen; swallowing quality; intensive care.
Description
Keywords
Competência profissional Deglutição Doença crítica Enfermagem médico cirúrgica Terapêutica por inalação de oxigénio Critical illness Deglutition Medical surgical nursing Oxygen inhalation therapy Professional competence