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Introdução: A primeira parte deste relatório descreve o percurso de estágio de natureza
profissional realizado no âmbito do Curso de Mestrado em Enfermagem Médico-
Cirúrgica, na área da Pessoa em Situação Crítica; a segunda parte apresenta uma
investigação, com foco na identificação de eventos adversos associados à colocação e
manutenção de cateteres centrais de inserção periférica (PICC) num hospital da região
Centro do país.
Objetivos: Demonstrar as competências especializadas adquiridas ao longo do
percurso formativo; identificar as principais complicações e eventos adversos
associados aos PICC, contribuindo para a melhoria da qualidade e segurança dos
cuidados.
Métodos: Exposição das competências adquiridas em contexto de estágio, com recurso
a uma metodologia descritiva e crítico-reflexiva. Ao nível da investigação, realizou-se
um estudo quantitativo, descritivo-correlacional e retrospetivo, com base na análise de
registos clínicos de pessoas submetidos à colocação de PICC numa unidade hospitalar
da região Centro.
Resultados: Os PICC foram, maioritariamente, utilizados em pessoas com
necessidades terapêuticas prolongadas, com predomínio da nutrição parentérica total
(41,56%), da terapêutica intravenosa prolongada (21,30%) e da ausência de acessos
periféricos (20%). A colocação apresentou elevada taxa de sucesso, com um número
médio reduzido de tentativas. Registo de uma incidência elevada de complicações
(73,5%), destacando-se as de natureza mecânica, infeciosa e inflamatória,
nomeadamente o dobramento do cateter (9,01%), bacteriémia (6,31%),
disfuncionalidade (5,41%) e sinais inflamatórios (5,41%). Não foram identificadas
associações estatisticamente significativas entre a ocorrência de complicações e as
variáveis analisadas (p>0,05).
Conclusão: Os estágios revelaram-se indispensáveis para o desenvolvimento e o
aprimoramento de competências especializadas em Enfermagem Médico-Cirúrgica. O
estudo desenvolvido demonstrou a complexidade associada à gestão dos PICC,
robustecendo a relevância da padronização de práticas, da formação contínua e da
prática baseada na evidência na promoção da segurança da pessoa e da qualidade dos
cuidados.
Palavras-chave: cateteres centrais de inserção periférica; complicações; segurança do
doente; enfermagem médico-cirúrgica; prática baseada na evidência
Abstract Introduction: The first part of this report describes the professional placement undertaken as part of the Master’s Degree in Medical-Surgical Nursing, in the area of Persons in Critical Situations; the second part presents a research study focusing on the identification of adverse events associated with the insertion and maintenance of peripherally inserted central catheters (PICC) in a hospital in the Central region of the country. Objectives: To demonstrate the specialist skills acquired throughout the training programme; to identify the main complications and adverse events associated with PICC lines, thereby contributing to the improvement of the quality and safety of care. Methods: This work presents the skills acquired during a clinical internship, using a descriptive and critical-reflective methodology. In terms of research, a quantitative, descriptive-correlational and retrospective study was conducted, based on the analysis of clinical records of patients who underwent PICC placement in a hospital unit in the Central region. Results: PICC lines were predominantly used in patients with prolonged therapeutic needs, with a predominance of total parenteral nutrition (41.56%), prolonged intravenous therapy (21.30%) and the absence of peripheral access (20%). Placement showed a high success rate, with a low average number of attempts. A high incidence of complications was recorded (73.5%), notably those of a mechanical, infectious and inflammatory nature, specifically catheter kinking (9.01%), bacteraemia (6.31%), dysfunction (5.41%) and inflammatory signs (5.41%). No statistically significant associations were identified between the occurrence of complications and the variables analysed (p>0.05). Conclusion: Clinical placements proved to be essential for the development and refinement of specialist skills in medical-surgical nursing. This study demonstrated the complexity associated with the management of PICC lines, reinforcing the importance of standardised practices, continuous training and evidence-based practice in promoting patient safety and the quality of care. Keywords: peripherally inserted central catheters; complications; patient safety; medical-surgical nursing; evidence-based practice
Abstract Introduction: The first part of this report describes the professional placement undertaken as part of the Master’s Degree in Medical-Surgical Nursing, in the area of Persons in Critical Situations; the second part presents a research study focusing on the identification of adverse events associated with the insertion and maintenance of peripherally inserted central catheters (PICC) in a hospital in the Central region of the country. Objectives: To demonstrate the specialist skills acquired throughout the training programme; to identify the main complications and adverse events associated with PICC lines, thereby contributing to the improvement of the quality and safety of care. Methods: This work presents the skills acquired during a clinical internship, using a descriptive and critical-reflective methodology. In terms of research, a quantitative, descriptive-correlational and retrospective study was conducted, based on the analysis of clinical records of patients who underwent PICC placement in a hospital unit in the Central region. Results: PICC lines were predominantly used in patients with prolonged therapeutic needs, with a predominance of total parenteral nutrition (41.56%), prolonged intravenous therapy (21.30%) and the absence of peripheral access (20%). Placement showed a high success rate, with a low average number of attempts. A high incidence of complications was recorded (73.5%), notably those of a mechanical, infectious and inflammatory nature, specifically catheter kinking (9.01%), bacteraemia (6.31%), dysfunction (5.41%) and inflammatory signs (5.41%). No statistically significant associations were identified between the occurrence of complications and the variables analysed (p>0.05). Conclusion: Clinical placements proved to be essential for the development and refinement of specialist skills in medical-surgical nursing. This study demonstrated the complexity associated with the management of PICC lines, reinforcing the importance of standardised practices, continuous training and evidence-based practice in promoting patient safety and the quality of care. Keywords: peripherally inserted central catheters; complications; patient safety; medical-surgical nursing; evidence-based practice
Descrição
Palavras-chave
Cateterização periférica Competência profissional Doença crítica Efeitos adversos Enfermagem médico cirúrgica Hospitais Adverse effects Catheterization peripheral Critical illness Hospitals Medical surgical nursing Professional competence