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Estratégias para a redução do impacto do ruído cirúrgico em cirurgias ortopédicas com anestesia loco regional-realidade virtual: Desenvolvimento de competências em Enfermagem Médico-Cirúrgica, na área da Enfermagem à Pessoa em Situação Perioperatória
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A área de especialização em Enfermagem à Pessoa em Situação Perioperatória, apresenta como
objetivo primordial, a prestação de cuidados à pessoa e família/pessoa significativa, a
vivenciarem a experiência cirúrgica/anestésica. A complexidade e a exigência dos cuidados na
área do perioperatório, associados a situações de imprevisibilidade e vulnerabilidade, bem como
às necessidades específicas de cada cliente, exige que o enfermeiro especialista, desenvolva e
mobilize um conjunto de competências e conhecimentos, que o capacitem a uma prática de
enfermagem avançada. Na procura destas competências, no âmbito do curso de Mestrado em
Enfermagem Médico-Cirúrgica na área de enfermagem à pessoa em situação perioperatória, foi
desenvolvido um estágio de natureza profissional, que culminou com a elaboração deste
relatório. O presente documento, visa, apresentar o projeto de desenvolvimento profissional
inicialmente delineado, relatando e refletindo sobre as atividades desenvolvidas, para alcançar
os objetivos estabelecidos.
Para isso, é apresentada a caracterização dos serviços onde decorreram os estágios de natureza
profissional, assim como as atividades executadas, na procura pelo desenvolvimento de
competências comuns e específicas inerentes à área de enfermagem à pessoa em situação
perioperatória. No âmbito da conceção de cuidados, foram elaborados planos de cuidados
individualizados, com recurso à plataforma educacional e4nursing, tendo em conta os
pressupostos da Ontologia da Enfermagem adotados quer pela Escola Superior de Enfermagem
do Porto, quer pela Ordem dos Enfermeiros.
As competências comuns desenvolvidas ao longo da prática clínica, centraram-se na
capacitação da pessoa em situação perioperatória e no desenvolvimento dos enfermeiros, por
meio de ações de formação, e partilha de conhecimento. Este processo, foi sustentado pela
gestão eficaz de cuidados, pela liderança clínica e pela participação ativa na conceção e
implementação de projetos de melhoria contínua da qualidade. Foram igualmente
desenvolvidas competências específicas no âmbito da Enfermagem Perioperatória, refletindo
um grau elevado de adequação dos cuidados às necessidades específicas do cliente e
família/pessoa significativa.
De modo a fundamentar o caso clínico, e dar resposta a uma preocupação que motivou o título
do projeto profissional que se apresenta, foi desenvolvida uma componente de investigação,
que teve especial enfoque ao longo de todo o estágio de desenvolvimento profissional,
contribuindo para a aquisição de competências em prática baseada em evidência. Nesse
sentido, foi realizada uma revisão sistemática da literatura intitulada “Estratégias para a redução do impacto do ruído cirúrgico em cirurgias ortopédicas sob anestesia loco regional sem
sedação: realidade virtual”. A revisão foi norteada pelas diretrizes do Joanna Briggs Institute,
englobando as etapas de definição metodológica, delineamento do estudo, análise e discussão
dos resultados, culminando numa síntese conclusiva rigorosa.
Os resultados da revisão indicaram que a utilização da realidade virtual durante cirurgias sob
anestesia loco-regional promove uma redução significativa da ansiedade, aumento da satisfação
dos clientes, menor uso de sedativos, além de melhor o relaxamento e estabilidade
hemodinâmica. A eficácia da realidade virtual foi observada tanto como ferramenta de distração
quanto como via hipnótica, destacando-se como uma estratégia eficaz para aprimorar a
experiência do cliente no contexto cirúrgico.
A componente de investigação, aliada ao desenvolvimento de competências comuns e
específicas, potenciou uma tomada de decisão clínica sustentada na melhor evidência,
promovendo cuidados de enfermagem mais qualificados, seguros e alinhados com os princípios
de excelência e humanização.
The specialization area in Perioperative Nursing, aims primarily to provide care to individuals and their families/significant others undergoing the surgical/anesthetic experience. The complexity and demands of care in the perioperative setting, characterized by unpredictability, vulnerability, and the specific needs of each patient, require the specialist nurse to develop and mobilize a set of skills and knowledge that enable advanced nursing practice. In pursuit of these competencies, within the scope of the Master’s Degree in Medical-Surgical Nursing, with a focus on Perioperative Nursing, a professional internship was undertaken, culminating in the preparation of this report. This document aims to present the initially outlined professional development project, detailing and reflecting on the activities carried out to achieve the established objectives. To this end, a characterization of the clinical settings where the professional internships took place is provided, as well as the activities performed in pursuit of developing both common and specific competencies related to nursing care for individuals in the perioperative context. As part of care planning, individualized care plans were developed using the e4nursing educational platform, based on the Nursing Ontology principles adopted by both Porto Nursing School and the Portuguese Order of Nurses. The common competencies developed throughout clinical practice focused on empowering the perioperative patient and supporting the professional development of nurses through training activities and knowledge sharing. This process was supported by effective care management, clinical leadership, and active participation in the design and implementation of continuous quality improvement projects. Specific competencies in Perioperative Nursing were also developed, reflecting a high degree of alignment between care delivery and the specific needs of patients and their families/significant others. To support the clinical case and address a concern that inspired the title of the professional project, a research component was developed. This component was a consistent focus throughout the professional development internship, contributing to the acquisition of evidencebased practice skills. A systematic literature review was conducted under the title: “Strategies to reduce the impact of surgical noise in orthopedic surgeries under regional anesthesia without sedation: virtual reality.” The review was guided by Joanna Briggs Institute guidelines, encompassing methodological definition, study design, result analysis and discussion, and concluding with a rigorous synthesis. The results of the review indicated that the use of virtual reality during surgeries under regional anesthesia promotes a significant reduction in anxiety, increased patient satisfaction, decreased use of sedatives, as well as improved relaxation and hemodynamic stability. The effectiveness of virtual reality was observed both as a distraction tool and as a hypnotic approach, highlighting it as an effective strategy to enhance the patient experience in the surgical context. The research component, combined with the development of both common and specific competencies, enhanced clinical decision-making based on the best evidence, promoting more qualified, safer nursing care, and aligning with the principles of excellence and humanization.
The specialization area in Perioperative Nursing, aims primarily to provide care to individuals and their families/significant others undergoing the surgical/anesthetic experience. The complexity and demands of care in the perioperative setting, characterized by unpredictability, vulnerability, and the specific needs of each patient, require the specialist nurse to develop and mobilize a set of skills and knowledge that enable advanced nursing practice. In pursuit of these competencies, within the scope of the Master’s Degree in Medical-Surgical Nursing, with a focus on Perioperative Nursing, a professional internship was undertaken, culminating in the preparation of this report. This document aims to present the initially outlined professional development project, detailing and reflecting on the activities carried out to achieve the established objectives. To this end, a characterization of the clinical settings where the professional internships took place is provided, as well as the activities performed in pursuit of developing both common and specific competencies related to nursing care for individuals in the perioperative context. As part of care planning, individualized care plans were developed using the e4nursing educational platform, based on the Nursing Ontology principles adopted by both Porto Nursing School and the Portuguese Order of Nurses. The common competencies developed throughout clinical practice focused on empowering the perioperative patient and supporting the professional development of nurses through training activities and knowledge sharing. This process was supported by effective care management, clinical leadership, and active participation in the design and implementation of continuous quality improvement projects. Specific competencies in Perioperative Nursing were also developed, reflecting a high degree of alignment between care delivery and the specific needs of patients and their families/significant others. To support the clinical case and address a concern that inspired the title of the professional project, a research component was developed. This component was a consistent focus throughout the professional development internship, contributing to the acquisition of evidencebased practice skills. A systematic literature review was conducted under the title: “Strategies to reduce the impact of surgical noise in orthopedic surgeries under regional anesthesia without sedation: virtual reality.” The review was guided by Joanna Briggs Institute guidelines, encompassing methodological definition, study design, result analysis and discussion, and concluding with a rigorous synthesis. The results of the review indicated that the use of virtual reality during surgeries under regional anesthesia promotes a significant reduction in anxiety, increased patient satisfaction, decreased use of sedatives, as well as improved relaxation and hemodynamic stability. The effectiveness of virtual reality was observed both as a distraction tool and as a hypnotic approach, highlighting it as an effective strategy to enhance the patient experience in the surgical context. The research component, combined with the development of both common and specific competencies, enhanced clinical decision-making based on the best evidence, promoting more qualified, safer nursing care, and aligning with the principles of excellence and humanization.
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Palavras-chave
Enfermagem Perioperatório Competências Ruído cirúrgico Realidade Virtual