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A intervenção do enfermeiro especialista em enfermagem de reabilitação na prevenção do declínio funcional da pessoa com fratura da extremidade proximal do fémur
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Advisor(s)
Abstract(s)
A fratura da extremidade proximal do fémur apresenta uma tendência
epidemiológica crescente. Está associada às alterações provocadas pelo
envelhecimento, que contribuem para um maior risco de queda com a idade. Por sua
vez, a imobilidade condicionada pela fratura induz o aparecimento de complicações,
perda de funcionalidade com impacto no autocuidado, exacerbação das
comorbilidades previamente existentes e aumento da mortalidade. Esta situação
legitima a intervenção do EEER no pré e pós-operatório, atuando na prevenção de
complicações, na manutenção da função existente e na reeducação funcional, com
foco na capacitação para o autocuidado e na reinserção social da pessoa.
Neste relatório de estágio pretendemos demonstrar, através da descrição e
análise das atividades implementadas, o desenvolvimento das competências do grau
de Mestre, explanadas nos Descritores de Dublin para o 2º ciclo de ensino, e o
desenvolvimento das competências comuns do Enfermeiro Especialista e das
competências específicas do Enfermeiro Especialista em Enfermagem de
Reabilitação, preconizadas pela Ordem dos Enfermeiros. Como referencial teórico
escolhemos a Teoria do Défice de Autocuidado em Enfermagem de Dorothea Orem,
uma vez que a diminuição da capacidade funcional provocada pela fratura leva ao
compromisso da capacidade de autocuidado. Efetuámos uma Revisão Narrativa da
Literatura para identificar as intervenções autónomas do EEER que previnem o
declínio funcional da pessoa com fratura da extremidade proximal do fémur.
Os resultados permitiram-nos identificar a avaliação multidimensional da
pessoa e família, e a avaliação funcional como perentórias para a elaboração de um
plano de cuidados ajustado ao potencial de reabilitação da pessoa. A implementação
de programas de reeducação funcional motora e respiratória no pré e pós-operatório,
que inclua treino de AVD, levante e treino de marcha precoce e que envolva a pessoa
e família/cuidador. A prevenção do declínio funcional não se esgota no internamento
hospitalar. É necessário assegurar a continuidade do programa de reabilitação após
a alta hospitalar e intervir tendo como missão a prevenção de complicações sobretudo
resultantes da vulnerabilidade acrescidas da pessoa/família.
The hip fracture presents an increasing epidemiological tendency. It is associated with changes caused by ageing, which contribute to a higher risk of related falls. In turn, the immobility conditioned by the fracture induces the emergence of complications, loss of functionality with impact on self-care, exacerbation of previously existing comorbidities and increased mortality. This situation legitimizes the intervention of the Nurse Specialist in Rehabilitation Nursing (NSRN) in the pre and postoperative period, acting in the prevention of complications, maintenance of the existing function and functional reeducation, focusing on training for self-care and on the social reintegration of the person. In this internship report we intend to demonstrate, through the description and analysis of the implemented activities, the development of the competencies of the Master's degree, explained in the Dublin Descriptors for the 2 nd cycle of teaching, and the development of the common competencies of the Specialist Nurse and the specific competencies of the Nurse Specialist in Rehabilitation Nursing, recommended by the Ordem dos Enfermeiros. We chose Dorothea Orem's Theory of Self-Care Deficit in Nursing as a theoretical reference, since the functional impairment caused by the fracture leads to the compromise of self-care competence. We carried out a Narrative Literature Review to identify the autonomous interventions of the NSRN that prevent the functional decline of the person with hip fracture. The results allowed us to identify the multidimensional evaluation of the person and family, and the functional evaluation as an imperative for the elaboration of a care plan adjusted to the rehabilitation potential of the person. The implementation of motor and respiratory functional reeducation programs in the pre and postoperative periods, which includes Daily Life Activities training, lifting and early gait training, involving the person and family/caregiver. The prevention of functional decline is not exhausted in hospital admission. It is necessary to ensure the continuity of the rehabilitation program after hospital discharge and to intervene to prevent complications, mainly resulting from the increased vulnerability of the person/family.
The hip fracture presents an increasing epidemiological tendency. It is associated with changes caused by ageing, which contribute to a higher risk of related falls. In turn, the immobility conditioned by the fracture induces the emergence of complications, loss of functionality with impact on self-care, exacerbation of previously existing comorbidities and increased mortality. This situation legitimizes the intervention of the Nurse Specialist in Rehabilitation Nursing (NSRN) in the pre and postoperative period, acting in the prevention of complications, maintenance of the existing function and functional reeducation, focusing on training for self-care and on the social reintegration of the person. In this internship report we intend to demonstrate, through the description and analysis of the implemented activities, the development of the competencies of the Master's degree, explained in the Dublin Descriptors for the 2 nd cycle of teaching, and the development of the common competencies of the Specialist Nurse and the specific competencies of the Nurse Specialist in Rehabilitation Nursing, recommended by the Ordem dos Enfermeiros. We chose Dorothea Orem's Theory of Self-Care Deficit in Nursing as a theoretical reference, since the functional impairment caused by the fracture leads to the compromise of self-care competence. We carried out a Narrative Literature Review to identify the autonomous interventions of the NSRN that prevent the functional decline of the person with hip fracture. The results allowed us to identify the multidimensional evaluation of the person and family, and the functional evaluation as an imperative for the elaboration of a care plan adjusted to the rehabilitation potential of the person. The implementation of motor and respiratory functional reeducation programs in the pre and postoperative periods, which includes Daily Life Activities training, lifting and early gait training, involving the person and family/caregiver. The prevention of functional decline is not exhausted in hospital admission. It is necessary to ensure the continuity of the rehabilitation program after hospital discharge and to intervene to prevent complications, mainly resulting from the increased vulnerability of the person/family.
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Keywords
Enfermagem em reabilitação Fratura do quadril Idoso Autocuidado