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Gestão física e o conhecimento da equipa multidisciplinar no Bloco Operatório na Prevenção de Infeção do Local Cirúrgico no Cliente submetido a Hernioplastia Inguinal
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Advisor(s)
Abstract(s)
O presente relatório final enquadra-se na conclusão do Estágio de Natureza Profissional com
relatório – Módulo II, no âmbito do Mestrado em Enfermagem Médico-cirúrgica, na área de
Enfermagem à Pessoa em Situação Perioperatória. Com este relatório pretendo descrever e
analisar criticamente o processo de desenvolvimento e aquisição de competências
especializadas em Enfermagem à Pessoa em Situação Perioperatória, através da exposição
fundamentada da aplicação das competências gerais para o Enfermeiro Especialista em
Enfermagem Médico-Cirúrgica e específicas na Área de Enfermagem à Pessoa em Situação
Perioperatória.
O estágio decorreu no bloco operatório de um hospital central da região norte do país.
Ao longo do contexto de estágio, o contributo para a aquisição de competências, traduziu-se na
procura e concretização de experiências, envolvendo as dimensões da prestação, da formação,
da gestão e da investigação, no sentido da aquisição, desenvolvimento e aperfeiçoamento de
competências do Enfermeiro Especialista em Enfermagem Médico-Cirúrgica.
Nesse sentido, emergiu a problemática da incidência da Infeção do Local Cirúrgico (ILC) em
clientes intervencionados a hernioplastia inguinal em regime de ambulatório no bloco operatório
em questão.
A investigação na área da prevenção da ILC, conduziu-me à necessidade de extrair dados
concretos do serviço relativos ao conhecimento das normas preventivas da ILC e da aplicação
da mais recente norma preventiva para esta problemática no país: Norma da DGS nº 020/2015
de 15/12/2015 atualizada a 17/11/2022. “Feixe de Intervenções” para a Prevenção da Infeção do
Local Cirúrgico.
Esta análise levou à reflexão sobre o assunto e induziu na equipa o espírito de mudança e
empreendedorismo com vista na segurança do cliente cirúrgico e na maximização da qualidade
dos cuidados prestados. Assim, foram aplicadas ações formativas às equipas de enfermagem e
assistentes operacionais em simultâneo com o desenvolvimento de uma proposta de alteração
estrutural numa área específica do bloco operatório e de um instrumento de monitorização da
higienização do mesmo espaço .
Com este trabalho, pretendi reforçar a formação e o enriquecimento dos conhecimentos
passíveis de implementar na atividade profissional diárias das equipas do bloco operatório e
deixar em aberto uma possibilidade de resposta para um espaço físico que se encontra
desajustado aos requisitos para a prevenção da contaminação no bloco operatório e na prevenção da ILC. Neste seguimento acredito que contribui para o aumento da qualidade dos
cuidados no bloco operatório e para a Enfermagem Perioperatória através da sistematização do
processo de tomada de decisão dos profissionais na abordagem ao cliente cirúrgico, mais
precisamente na gestão do risco de desenvolvimento de ILC com ponto de partida no ambiente
perioperatório.
A aplicação da proposta de estruturação sala h e do instrumento de monitorização higiénica
permitirá aos profissionais contribuir para a realização de intervenções autónomas favoráveis à
prevenção da ILC.
Da experiência de estágio de natureza profissional, salienta-se o papel essencial do Enfermeiro
Especialista em Enfermagem Médico-Cirúrgica e na Área de Enfermagem à Pessoa em Situação
Perioperatória no bloco operatório na promoção da aquisição de conhecimentos técnicos e
científicos na equipa multidisciplinar e na gestão diferenciada de cuidados de enfermagem, em
prol da melhoria contínua da qualidade dos cuidados prestados no contexto do perioperatório.
A nível pessoal, elevo a oportunidade de experiências e aprendizagens profissionais
diferenciadas, e a excelente integração em toda a equipa do bloco o que me permitiu viver
momentos únicos de aprendizagem e enriquecimento pessoal, formativo e profissional.
Esta vivência afirmou a minha consciencialização quanto à importância da prática
fundamentada no pensamento crítico, patenteada pela evidência científica, numa continuidade
pela busca do “savoir-être e savoir-faire” ao longo da vida a nível pessoal e profissional.
This final report means to be part of the conclusion of the Professional Internship with report - Module II, within the scope of the Master's Degree in Medical-Surgical Nursing, in the area of Perioperative Nursing. Its aim is to describe and critically analyze the process of developing and acquiring specialized skills in Nursing for People in Perioperative Situations, through a reasoned presentation of the application of the general skills for the Specialist Nurse in Medical-Surgical Nursing and specific skills in the area of Nursing for People in Perioperative Situations. The internship took place in the operating room of a central hospital in the north of Portugal. Throughout the internship, the acquisition of skills was made through the search for and undertaking of tasks involving the dimensions of provision, training, management and research, in order to acquire, develop and improve the skills of the Specialist Nurse in Medical-Surgical Nursing. Thus, the problem of the incidence of Surgical Site Infection in clients undergoing outpatient inguinal hernioplasty in the operating room in question emerged. Research in the area of Surgical Site Infection prevention revealed the need to extract concrete data from the service regarding knowledge of the preventive standards for Surgical Site Infection and the application of the most recent preventive standard for this problem in the country: Portugal’s Directorate of General Health Standard No. 020/2015 of 15/12/2015 updated on 17/11/2022. "Bundle of Interventions" for the Prevention of Surgical Site Infection. This analysis prompted reflection on the subject and ignited a spirit of change and entrepreneurship in the team, aiming to the safety of the surgical client and maximizing the quality of care provided. As a result, training sessions were given to the nursing teams and operational assistants, as well as the development of a proposal for structural change in a specific area of the operating room, and a tool for monitoring hygiene in the same setting. With this work, I aimed to enhance the training and the knowledge that can be given in the daily professional activity of the operating room teams, and open up the possibility of a response to a physical space that is out of tune with the requirements for the prevention of contamination in the operating room and the prevention of Surgical Site Infection. In this respect, I believe it contributes to increasing the quality of care in the operating room and for Perioperative Nursing by systematizing the decision-making process of professionals in their approach to surgical clients, more precisely in managing the risk of developing Surgical Site Infections, with the perioperative environment as its starting point The application of the proposal for structuring room h and the hygiene monitoring tool will enable professionals to contribute to carrying out autonomous interventions favorable to the prevention of Surgical Site Infections. From the internship experience of a professional nature, the essential role of the Nurse Specialist in Medical-Surgical Nursing and in the Area of Perioperative Nursing in the operating room in promoting the acquisition of technical and scientific knowledge in the multidisciplinary team and in the differentiated management of nursing care, in favor of the continuous improvement of the quality of care provided in the perioperative context, stands out. On a personal level, I would like to highlight the opportunity for differentiated professional experiences and learning, and the excellent integration with the whole team in the bloc, which has allowed me to experience unique learning, as well as of personal, educational and professional enrichment moments. This experience promoted my awareness of the importance of practice based on critical thinking, as evidenced by scientific evidence, in a continuing search for "savoir-être and savoirfaire" throughout my personal and professional life.
This final report means to be part of the conclusion of the Professional Internship with report - Module II, within the scope of the Master's Degree in Medical-Surgical Nursing, in the area of Perioperative Nursing. Its aim is to describe and critically analyze the process of developing and acquiring specialized skills in Nursing for People in Perioperative Situations, through a reasoned presentation of the application of the general skills for the Specialist Nurse in Medical-Surgical Nursing and specific skills in the area of Nursing for People in Perioperative Situations. The internship took place in the operating room of a central hospital in the north of Portugal. Throughout the internship, the acquisition of skills was made through the search for and undertaking of tasks involving the dimensions of provision, training, management and research, in order to acquire, develop and improve the skills of the Specialist Nurse in Medical-Surgical Nursing. Thus, the problem of the incidence of Surgical Site Infection in clients undergoing outpatient inguinal hernioplasty in the operating room in question emerged. Research in the area of Surgical Site Infection prevention revealed the need to extract concrete data from the service regarding knowledge of the preventive standards for Surgical Site Infection and the application of the most recent preventive standard for this problem in the country: Portugal’s Directorate of General Health Standard No. 020/2015 of 15/12/2015 updated on 17/11/2022. "Bundle of Interventions" for the Prevention of Surgical Site Infection. This analysis prompted reflection on the subject and ignited a spirit of change and entrepreneurship in the team, aiming to the safety of the surgical client and maximizing the quality of care provided. As a result, training sessions were given to the nursing teams and operational assistants, as well as the development of a proposal for structural change in a specific area of the operating room, and a tool for monitoring hygiene in the same setting. With this work, I aimed to enhance the training and the knowledge that can be given in the daily professional activity of the operating room teams, and open up the possibility of a response to a physical space that is out of tune with the requirements for the prevention of contamination in the operating room and the prevention of Surgical Site Infection. In this respect, I believe it contributes to increasing the quality of care in the operating room and for Perioperative Nursing by systematizing the decision-making process of professionals in their approach to surgical clients, more precisely in managing the risk of developing Surgical Site Infections, with the perioperative environment as its starting point The application of the proposal for structuring room h and the hygiene monitoring tool will enable professionals to contribute to carrying out autonomous interventions favorable to the prevention of Surgical Site Infections. From the internship experience of a professional nature, the essential role of the Nurse Specialist in Medical-Surgical Nursing and in the Area of Perioperative Nursing in the operating room in promoting the acquisition of technical and scientific knowledge in the multidisciplinary team and in the differentiated management of nursing care, in favor of the continuous improvement of the quality of care provided in the perioperative context, stands out. On a personal level, I would like to highlight the opportunity for differentiated professional experiences and learning, and the excellent integration with the whole team in the bloc, which has allowed me to experience unique learning, as well as of personal, educational and professional enrichment moments. This experience promoted my awareness of the importance of practice based on critical thinking, as evidenced by scientific evidence, in a continuing search for "savoir-être and savoirfaire" throughout my personal and professional life.
Description
Keywords
Prevenção de Infeção Bloco Operatório Hernioplastia Inguinal Cirurgia Relatório de estágio