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A segurança da pessoa em situação crítica com delirium :
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Abstract(s)
O Delirium é uma condição clínica descrita como falência cerebral, com riscos graves para o
doente (Lamond, Murray, & Gibson, 2018). A principal premissa do Delirium é, por definição, uma
alteração psicofisiológica relacionada com toda a atividade sensorial do doente, regulação entre sistema
simpático e parassimpático, na resposta a estímulos stressores, motivados por doença, iatrogenias e
alterações ambientais (Lamond et al., 2018).
A incidência de Delirium numa Unidade de Cuidados Intensivos ronda entre os 60% a 80%
(Athanasakis, 2012). A prevenção, deteção e tratamento das causas que predispõem o Delirium são
fundamentais para diminuir a taxa de mortalidade associada ao mesmo (10%), co morbilidades, tempos
prolongados de internamento (Nelson, 2009).
No âmbito da Unidade Curricular Estágio com Relatório do 9º Curso de Mestrado em
Enfermagem na Área de Especialização Pessoa em Situação Crítica, da Escola de Enfermagem de
Lisboa, foi proposta a realização de um relatório de estágio, compilando as experiências formativas que
definiram o percurso de aquisição e desenvolvimento de competências especializadas de enfermagem
segundo os Descritores de Dublin relativos ao 2º ciclo do ensino superior e nas competências gerais e
especificas exigidas pela Ordem dos Enfermeiros. A prestação de cuidados à PSC foi desenvolvida em
contexto de Serviço de Urgência Polivalente e Unidade de Cuidados Intensivos, com enfoque na área
temática escolhida – “A segurança da Pessoa em Situação Crítica com Delirium: Intervenção
especializada de Enfermagem”.
Ancorado nos modelos teóricos Nursing as Caring (Boykin & Schoenhofer, 2013) e The Fundamentals
of Care Framework (Kitson, Conroy, Kuluski, Locock, & Lyons, 2013), declarando os objetivos
propostos e as atividades realizadas, pretende-se explanar e enquadrar os resultados obtidos que
permitiram alcançar a mobilização de novos conhecimentos baseados na experiência e evidência
científica, aplicação contínua de um julgamento clínico crítico, garantindo a intencionalidade no ato de
cuidar da pessoa em situação crítica e família.
Delirium is a clinical condition described as brain failure, with serious risks for the patient (Lamond, Murray, & Gibson, 2018). The main premise of Delirium is, by definition, a psychophysiological alteration related to the entire patient's sensory activity, regulation between the sympathetic and parasympathetic system, in response to stressor stimuli, motivated by acute disease, iatrogenies and environmental changes (Lamond et al., 2018). The incidence of Delirium in an Intensive Care Unit ranges from 60% to 80% (Athanasakis, 2012). The prevention, detection and treatment of the causes that predispose Delirium are essential to decrease the mortality rate associated with it (10%), with morbidities, prolonged hospitalization times (Nelson, 2009). Within the scope of the Internship of the 9th Master's Degree Course in Specialized Nursing Care to Critical Care Patients, from Escola Superior de Enfermagem de Lisboa, it was proposed to carry out an internship report, compiling the training experiences that defined the path of acquisition and development of specialized nursing skills according to the Dublin and general and specific skills required by the Ordem dos Enfermeiros. The provision of care to PSC was developed in the context of the Multipurpose Emergency Department and the Intensive Care Unit, with a focus on the chosen thematic area - “Promotion of safety in the care of People in Critical Situation with Delirium: Specialized Nursing Intervention”. Anchored in the theoretical models as Nursing as Caring (Boykin & Schoenhofer, 2013) and The Fundamentals of Care Framework (Kitson et al., 2013), declaring the proposed objectives and the activities carried out, it is intended to explain and frame the results obtained that allowed to reach the mobilization of new knowledge based on experience and scientific evidence, continuous application of critical clinical judgment, ensuring intentionality in the act of caring for the person in critical situation and family.
Delirium is a clinical condition described as brain failure, with serious risks for the patient (Lamond, Murray, & Gibson, 2018). The main premise of Delirium is, by definition, a psychophysiological alteration related to the entire patient's sensory activity, regulation between the sympathetic and parasympathetic system, in response to stressor stimuli, motivated by acute disease, iatrogenies and environmental changes (Lamond et al., 2018). The incidence of Delirium in an Intensive Care Unit ranges from 60% to 80% (Athanasakis, 2012). The prevention, detection and treatment of the causes that predispose Delirium are essential to decrease the mortality rate associated with it (10%), with morbidities, prolonged hospitalization times (Nelson, 2009). Within the scope of the Internship of the 9th Master's Degree Course in Specialized Nursing Care to Critical Care Patients, from Escola Superior de Enfermagem de Lisboa, it was proposed to carry out an internship report, compiling the training experiences that defined the path of acquisition and development of specialized nursing skills according to the Dublin and general and specific skills required by the Ordem dos Enfermeiros. The provision of care to PSC was developed in the context of the Multipurpose Emergency Department and the Intensive Care Unit, with a focus on the chosen thematic area - “Promotion of safety in the care of People in Critical Situation with Delirium: Specialized Nursing Intervention”. Anchored in the theoretical models as Nursing as Caring (Boykin & Schoenhofer, 2013) and The Fundamentals of Care Framework (Kitson et al., 2013), declaring the proposed objectives and the activities carried out, it is intended to explain and frame the results obtained that allowed to reach the mobilization of new knowledge based on experience and scientific evidence, continuous application of critical clinical judgment, ensuring intentionality in the act of caring for the person in critical situation and family.
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Keywords
Enfermagem de cuidados intensivos Cuidados críticos Unidades de cuidados intensivos Serviço hospitalar de emergência