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Consultas de acompanhamento de enfermagem de reabilitação à pessoa submetida a artroplastia total da anca: Uma perspetiva de gestão
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O envelhecimento populacional tem conduzido a um aumento expressivo das doenças osteoarticulares, nomeadamente a coxartrose, com impacto significativo na perda de autonomia e qualidade de vida. A artroplastia total da anca é a intervenção cirúrgica mais realizada e eficaz neste contexto, mas persistem fragilidades no acompanhamento pós-operatório, nomeadamente na continuidade e integração dos cuidados. Este projeto propõe e analisa a viabilidade de um modelo estruturado de consulta de acompanhamento pós-artroplastia total da anca, conduzido pelo Enfermeiro Especialista em Enfermagem de Reabilitação, numa perspetiva de qualidade, eficiência e sustentabilidade, orientado pelos referenciais de Donabedian, Deming, Porter e pela Ordem dos Enfermeiros.
Desenvolvido segundo a Metodologia de Trabalho de Projeto, identificaram-se lacunas estruturais e processuais no modelo atual e definiram-se indicadores de qualidade, valor e experiência da pessoa cuidada. Os resultados projetados apontam para ganhos funcionais, psicossociais e organizacionais, reforçando a autonomia da pessoa, a eficiência dos recursos e a sustentabilidade institucional.
A proposta organiza-se em três consultas sequenciais: a primeira presencial, centrada na avaliação funcional e no planeamento da reabilitação; a segunda, preferencialmente presencial, de acompanhamento e reforço educativo; e a terceira, preferencialmente em formato remoto, dedicada à monitorização da evolução e promoção da autogestão. Esta estrutura assegura continuidade, acessibilidade e adequação às necessidades específicas desta população.
Conclui-se que esta proposta constitui uma resposta inovadora e exequível, com potencial para reforçar a qualidade, a continuidade e o valor dos cuidados de reabilitação, contribuindo para a consolidação da Enfermagem de Reabilitação como área de excelência clínica e de liderança e sustentabilidade em saúde.
Population ageing has led to a marked increase in osteoarticular diseases, particularly coxarthrosis, with a significant impact on autonomy and quality of life. Total hip arthroplasty is the most frequently performed and effective surgical intervention in this context; however, notable weaknesses persist in postoperative follow-up, particularly regarding the continuity and integration of care. This project proposes and analyses the feasibility of a structured model of post–total hip arthroplasty follow-up consultation, led by the Specialist Nurse in Rehabilitation Nursing, from a perspective of quality, efficiency, and sustainability. The model is guided by the theoretical frameworks of Donabedian, Deming, Porter, and the Portuguese Order of Nurses. Developed according to the Project Work Methodology, the study identified structural and procedural gaps within the current model and defined quality, value, and patient experience indicators. The projected results indicate potential functional, psychosocial, and organisational gains, reinforcing patient autonomy, resource efficiency, and institutional sustainability. The proposal is structured into three sequential consultations: the first, in-person, focused on functional assessment and rehabilitation planning; the second, preferably in-person, dedicated to follow-up and educational reinforcement; and the third, preferably remote, aimed at monitoring progress and promoting self-management. This structure ensures continuity, accessibility, and responsiveness to the specific needs of this population. It is concluded that this proposal constitutes an innovative and feasible response, with potential to enhance the quality, continuity, and value of rehabilitation care, contributing to the consolidation of Rehabilitation Nursing as a field of clinical excellence, leadership, and sustainability in healthcare.
Population ageing has led to a marked increase in osteoarticular diseases, particularly coxarthrosis, with a significant impact on autonomy and quality of life. Total hip arthroplasty is the most frequently performed and effective surgical intervention in this context; however, notable weaknesses persist in postoperative follow-up, particularly regarding the continuity and integration of care. This project proposes and analyses the feasibility of a structured model of post–total hip arthroplasty follow-up consultation, led by the Specialist Nurse in Rehabilitation Nursing, from a perspective of quality, efficiency, and sustainability. The model is guided by the theoretical frameworks of Donabedian, Deming, Porter, and the Portuguese Order of Nurses. Developed according to the Project Work Methodology, the study identified structural and procedural gaps within the current model and defined quality, value, and patient experience indicators. The projected results indicate potential functional, psychosocial, and organisational gains, reinforcing patient autonomy, resource efficiency, and institutional sustainability. The proposal is structured into three sequential consultations: the first, in-person, focused on functional assessment and rehabilitation planning; the second, preferably in-person, dedicated to follow-up and educational reinforcement; and the third, preferably remote, aimed at monitoring progress and promoting self-management. This structure ensures continuity, accessibility, and responsiveness to the specific needs of this population. It is concluded that this proposal constitutes an innovative and feasible response, with potential to enhance the quality, continuity, and value of rehabilitation care, contributing to the consolidation of Rehabilitation Nursing as a field of clinical excellence, leadership, and sustainability in healthcare.
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Indicadores de gestão Enfermagem de reabilitação Artroplastia do quadril Encaminhamento e consulta continuidade de assistência ao paciente