Loading...
Publication
Influência do tempo na definição precoce do diagnóstico de enfarte agudo do miocárdio com elevação do segmento ST
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 8.17 MB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
Introdução: A realização de estágios em contexto de urgência e cuidados intensivos constitui um eixo fundamental no desenvolvimento das competências do enfermeiro especialista em Enfermagem Médico-Cirúrgica, na área de Enfermagem à pessoa em Situação Crítica. A Enfermagem, enquanto ciência, fundamenta-se na investigação para desenvolver conhecimentos que sustentem práticas baseadas na evidência e promovam cuidados de saúde mais seguros, eficazes e humanizados. Permite não apenas a compreensão aprofundada dos fenómenos em saúde e doença, mas também, fundamentar intervenções que respondam de forma eficaz e pertinente às necessidades das populações. Neste âmbito, a investigação sobre a influência da aquisição precoce de eletrocardiograma (ECG) em situações de Enfarte Agudo do Miocárdio com Supradesnivelamento do segmento ST (EAMcSST), revela-se crucial, salientado a importância da atuação atempada e tecnicamente informada do enfermeiro enquanto interveniente na deteção precoce e encaminhamento oportuno dos doentes com este tipo de emergência cardiovascular.
Objetivos: Demonstrar a aquisição das competências comuns e específicas em Enfermagem Médico-Cirúrgica, na área de Enfermagem à pessoa em Situação Crítica; Destacar a influência do tempo porta-ECG no diagnóstico precoce de EAMcSST.
Métodos: Análise das competências adquiridas nos estágios em contexto de urgência e em contexto de cuidados intensivos; Descrição do estudo desenvolvido, do tipo observacional, retrospetivo e de abordagem quantitativa, realizado num hospital da região centro de Portugal.
Resultados: Serviço de urgência e cuidados intensivos são ambientes marcados por elevada complexidade clínica e necessidade de resposta célere, favorecem a consolidação de competências técnico-científicas, o raciocínio clínico e capacidade de atuação em situações de instabilidade hemodinâmica. No estudo desenvolvido foram incluídos 55 doentes com diagnóstico de alta de EAMcSST. Observou-se uma proporção reduzida de casos em que o ECG foi realizado num tempo até 10 minutos (29,1%). Identificou-se uma associação estatisticamente significativa entre a aquisição precoce de ECG e o atendimento oportuno para cumprimento do tempo recomendado para reperfusão coronária até 120 minutos. A análise permitiu ainda identificar fatores de associação de cumprimento da meta temporal, nomeadamente: idade menor ou igual a 55 anos, tabagismo, utilização do fluxograma “dor torácica”, discriminador “dor precordial”, atribuição de prioridade clínica “laranja” e requisição de ECG no momento da triagem.
Conclusão: Os objetivos delineados para os estágios foram atingidos e as competências adquiridas. Os resultados do estudo de investigação reforçam a importância do tempo porta- ECG na abordagem inicial e diagnóstico precoce do doente com Enfarte Agudo do Miocárdio com Supradesnivelamento do segmento ST, destacando-o como um indicador sensível da qualidade assistencial em contexto de urgência.
Palavras-Chave: Enfermagem Médico-Cirúrgica; Investigação; Tempo porta-ECG; EAMcSST
Abstract Introduction: Clinical placements in emergency and intensive care settings play a fundamental role in the development of competencies for the nurse specialist in Medical-Surgical Nursing, specifically in the area of Critical Care Nursing. Nursing, as a science, is grounded in research aimed at developing knowledge that supports evidence-based practice and promotes safer, more effective, and humanized healthcare. It allows not only a deeper understanding of health and disease phenomena, but also supports the development of interventions that effectively and appropriately address population needs. In this context, research into the influence of early electrocardiogram (ECG) acquisition in cases of ST-Elevation Myocardial Infarction (STEMI) is crucial, emphasizing the importance of timely and technically informed nursing action in the early detection and prompt referral of patients experiencing such cardiovascular emergencies. Objectives: To demonstrate the acquisition the common and specific skills in Medical-Surgical Nursing within the scope of care for critically ill patients; To highlight the influence of door- to-ECG time on the early diagnosis of ST-Segment Elevation Myocardial Infarction (STEMI). Methods: Analysis of the skills acquired during interships in emergency and intensive care settings; Description of a quantitative, observational and retrospective study conducted at a hospital in central district of Portugal. Results: Emergency and intensive care units are characterized by high clinical complexity and the need for rapid response. These settings foster the consolidation of technical and scientific competencies, clinical reasoning, and the ability to act in the hemodynamically unstable situations. The study developed included 55 patients discharged with a diagnosis of STEMI. A low proportion of cases were observed in which th ECG was performed within until 10 minutes (29,1%). A statistically significant association was identified betweem early ECG acquisition and timely care, meeting the recommended reperfusion time through primary percutaneous coronary intervention within 120 minutes. The analysis also identified factors associated with meeting this time target, namely: age less than or equal to 55 years, smoking status, use of the “chest pain” flowchart, “precordial pain” as a discriminator, assignment of “orange” clinical priority, and ECG request at the time of triage. Conclusion: The objectives defined for the internships were achieved, and the expected skills were acquired. The results of the research study reinforce the importance of door-to-ECG time in the initial assessment and early diagnosis of patients with ST-Segment Elevation Myocardial Infarction, highlighting it as a sensitive indicator of quality of care in emergency settings. Keywords: Medical-Surgical Nursing; Research; Door-to-ECG time; STEMI
Abstract Introduction: Clinical placements in emergency and intensive care settings play a fundamental role in the development of competencies for the nurse specialist in Medical-Surgical Nursing, specifically in the area of Critical Care Nursing. Nursing, as a science, is grounded in research aimed at developing knowledge that supports evidence-based practice and promotes safer, more effective, and humanized healthcare. It allows not only a deeper understanding of health and disease phenomena, but also supports the development of interventions that effectively and appropriately address population needs. In this context, research into the influence of early electrocardiogram (ECG) acquisition in cases of ST-Elevation Myocardial Infarction (STEMI) is crucial, emphasizing the importance of timely and technically informed nursing action in the early detection and prompt referral of patients experiencing such cardiovascular emergencies. Objectives: To demonstrate the acquisition the common and specific skills in Medical-Surgical Nursing within the scope of care for critically ill patients; To highlight the influence of door- to-ECG time on the early diagnosis of ST-Segment Elevation Myocardial Infarction (STEMI). Methods: Analysis of the skills acquired during interships in emergency and intensive care settings; Description of a quantitative, observational and retrospective study conducted at a hospital in central district of Portugal. Results: Emergency and intensive care units are characterized by high clinical complexity and the need for rapid response. These settings foster the consolidation of technical and scientific competencies, clinical reasoning, and the ability to act in the hemodynamically unstable situations. The study developed included 55 patients discharged with a diagnosis of STEMI. A low proportion of cases were observed in which th ECG was performed within until 10 minutes (29,1%). A statistically significant association was identified betweem early ECG acquisition and timely care, meeting the recommended reperfusion time through primary percutaneous coronary intervention within 120 minutes. The analysis also identified factors associated with meeting this time target, namely: age less than or equal to 55 years, smoking status, use of the “chest pain” flowchart, “precordial pain” as a discriminator, assignment of “orange” clinical priority, and ECG request at the time of triage. Conclusion: The objectives defined for the internships were achieved, and the expected skills were acquired. The results of the research study reinforce the importance of door-to-ECG time in the initial assessment and early diagnosis of patients with ST-Segment Elevation Myocardial Infarction, highlighting it as a sensitive indicator of quality of care in emergency settings. Keywords: Medical-Surgical Nursing; Research; Door-to-ECG time; STEMI
Description
Keywords
Enfarte do miocárdio com elevação do segmento ST Enfarte agudo do miocárdio com elevação do segmento ST - diagnóstico Enfermagem médico cirúrgica Fatores de tempo Medical surgical nursing ST elevation myocardial infarction ST elevation myocardial infarction - diagnosis
Pedagogical Context
Citation
Publisher
CC License
Without CC licence