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Conhecimento dos Enfermeiros do serviço de urgência sobre via verde sépsis na pessoa em situação crítica: impacto de uma atividade formativa
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Abstract(s)
O presente relatório foi desenvolvido no âmbito do mestrado de Enfermagem Médico-Cirúrgica na área da pessoa em situação crítica. A sua elaboração encontra-se estruturada em duas partes. A primeira parte apresenta uma análise reflexiva sobre as experiências vivenciadas nos diferentes contextos clínicos que contribuíram para a aquisição e desenvolvimento de competências gerais e específicas do Enfermeiro Especialista em Enfermagem Médico Cirúrgica à pessoa em situação crítica. A segunda parte expõe o trabalho de investigação desenvolvido no domínio da via verde sépsis (VVS), com o objetivo de analisar o contributo de uma atividade formativa para o desenvolvimento dos conhecimentos dos enfermeiros do serviço de urgência sobre a VVS na abordagem da pessoa em situação crítica.
A sépsis, designada por uma reação inflamatória generalizada do organismo em resposta a um foco infecioso, instalado em qualquer órgão do corpo humano. Atualmente é uma preocupação a nível mundial, sendo responsável por uma das principais causas de mortalidade e morbilidade em todo mundo. A sépsis e o choque séptico são uma emergência clínica, sendo o seu reconhecimento precoce determinante para o tratamento eficaz. O reconhecimento precoce exige das equipas de Enfermagem do Serviço de Urgência conhecimentos sobre os sintomas sugestivos de sépsis.
Foi realizado um estudo quase-experimental com delineamento intragrupo, de cariz quantitativo, a uma amostra de 61 enfermeiros de um Serviço de Urgência do Norte de Portugal, que se disponibilizou a participar no estudo de forma voluntária. O instrumento de recolha de dados utilizado foi o questionário, realizado e construído por Caulino (2021). No estudo foi aplicado o questionário pré e pós implementação de atividade formativa sobre VVS, para avaliar o contributo da formação no conhecimento da amostra do estudo. A amostra é predominantemente do sexo feminino, com idade compreendida entre os 31 e os 40 anos, maioritariamente detentores de pós-graduação em Emergência/Trauma, com média de 10,8 anos de experiência profissional, e de 6,5 anos de experiência profissional em serviço de urgência. Antes da implementação da atividade formativa, 3,3% da amostra enquadrava-se no nível de conhecimento sobre VVS classificado como muito mau, 13,1% no nível de conhecimentos classificado como mau, 55,7% no nível de conhecimento razoável, 26,2%% no nível bom e 1,6% da amostra no nível muito bom. Após a implementação da formação constatou-se que nenhum participante apresentou níveis de conhecimento muito mau ou mau, e a percentagem de participantes com nível de conhecimento razoável, diminuiu para 14,8%, o nível de conhecimento bom aumentou para 42,6%, no nível de conhecimento muito bom pré e pós formação verificou-se um aumento significativo de 1,6% para 42,6% da amostra.
Os diferentes ensinos clínicos permitiram vivenciar um vasto contacto com a pessoa em situação crítica, contribuíram para o desenvolvimento e aperfeiçoamento de competências especificas do Enfermeiro Especialista em Enfermagem Médico-Cirúrgica na área da pessoa em situação critica. A competência do cuidar da pessoa, família a vivenciar processos complexos de doença critica foi uma prática diária dos vários campos de estágio. Para tal o enfermeiro deve ser detentor de conhecimentos que lhe permitam responder de forma rápida e holística à pessoa em situação crítica.A formação implementada mostrou ser um pilar fundamental para dar resposta ao domínio do desenvolvimento das aprendizagens profissionais. É imperioso que os enfermeiros no serviço de urgência sejam detentores de um conhecimento aprofundado dos sinais e sintomas sugestivos de ativação de VVS, considerando ser os primeiros profissionais de saúde que contactam com o doente.
This report was developed as part of the Medical-Surgical Nursing master's degree in critical care. The structure is divided into two sections. The first part presents a reflective analysis of the experiences in the different clinical contexts that contributed to the acquisition and development of the general and specific competences of the Nurse Specialist in Medical-Surgical Nursing for the critically ill person. The second part of the report presents the research carried out on the via verde sepsis (VVS) topic. The study aimed to analyze the contribution of a training activity to developing emergency department nurses' knowledge of VVS in the approach to the critically ill person. Sepsis is a generalized inflammatory reaction of the body in response to an infectious outbreak in any organ of the human body. It is a global concern that must be addressed, as it is responsible for one of the main causes of mortality and morbidity worldwide. Sepsis and septic shock are clinical emergencies, and early recognition is crucial for effective treatment. Early recognition of sepsis symptoms by Emergency Department nursing teams is crucial. A quantitative quasi-experimental study with an intra-group design was conducted with a sample of 61 nurses from an emergency department in the northern region of Portugal, who volunteered to take part in the study. The data collection instrument employed was a questionnaire designed and constructed by Caulino (2021). The pre- and post-implementation questionnaires were utilized to evaluate the impact of the training on the knowledge of the study sample. The sample was predominantly female, with an average age of 31 to 40 years, and most of the participants had a postgraduate degree in Emergency/Trauma. The average professional experience in emergency services was 10.8 years, and the average professional experience in the field was 6.5 years. Prior to the implementation of the training activity, 3.3% of the sample exhibited a very poor level of knowledge regarding VVS, 13.1% demonstrated a poor level of knowledge, 55.7% exhibited a reasonable level of knowledge, 26.2% displayed a good level of knowledge, and 1.6% of the sample demonstrated a very good level of knowledge. Following the implementation of the training, it was ascertained that none of the participants exhibited a poor or substandard level of knowledge. The proportion of participants possessing a reasonable level of knowledge diminished to 14.8%, while the proportion with a commendable level of knowledge increased to 42.6%. Moreover, the proportion with an exceptional level of knowledge exhibited a substantial increase from 1.6% to 42.6% of the sample before and after the training. The diverse clinical courses during the master's, enabled extensive interaction with critically ill patients, thereby facilitating the development and refinement of the specific competencies of the Medical-Surgical Nurse Specialist in the domain of critical care. The ability to care for individuals and families encountering complex critical illness processes was a daily occurrence in the various internship fields. To achieve this, nurses must possess the knowledge to respond quickly and holistically to people in critical situations. The training provided was found to be a fundamental pillar for responding to the development of professional learning. Nurses in the emergency department must possess in-depth knowledge of the signs and symptoms suggestive of VVS activation, as they are the first health professionals to come into contact with the patient.
This report was developed as part of the Medical-Surgical Nursing master's degree in critical care. The structure is divided into two sections. The first part presents a reflective analysis of the experiences in the different clinical contexts that contributed to the acquisition and development of the general and specific competences of the Nurse Specialist in Medical-Surgical Nursing for the critically ill person. The second part of the report presents the research carried out on the via verde sepsis (VVS) topic. The study aimed to analyze the contribution of a training activity to developing emergency department nurses' knowledge of VVS in the approach to the critically ill person. Sepsis is a generalized inflammatory reaction of the body in response to an infectious outbreak in any organ of the human body. It is a global concern that must be addressed, as it is responsible for one of the main causes of mortality and morbidity worldwide. Sepsis and septic shock are clinical emergencies, and early recognition is crucial for effective treatment. Early recognition of sepsis symptoms by Emergency Department nursing teams is crucial. A quantitative quasi-experimental study with an intra-group design was conducted with a sample of 61 nurses from an emergency department in the northern region of Portugal, who volunteered to take part in the study. The data collection instrument employed was a questionnaire designed and constructed by Caulino (2021). The pre- and post-implementation questionnaires were utilized to evaluate the impact of the training on the knowledge of the study sample. The sample was predominantly female, with an average age of 31 to 40 years, and most of the participants had a postgraduate degree in Emergency/Trauma. The average professional experience in emergency services was 10.8 years, and the average professional experience in the field was 6.5 years. Prior to the implementation of the training activity, 3.3% of the sample exhibited a very poor level of knowledge regarding VVS, 13.1% demonstrated a poor level of knowledge, 55.7% exhibited a reasonable level of knowledge, 26.2% displayed a good level of knowledge, and 1.6% of the sample demonstrated a very good level of knowledge. Following the implementation of the training, it was ascertained that none of the participants exhibited a poor or substandard level of knowledge. The proportion of participants possessing a reasonable level of knowledge diminished to 14.8%, while the proportion with a commendable level of knowledge increased to 42.6%. Moreover, the proportion with an exceptional level of knowledge exhibited a substantial increase from 1.6% to 42.6% of the sample before and after the training. The diverse clinical courses during the master's, enabled extensive interaction with critically ill patients, thereby facilitating the development and refinement of the specific competencies of the Medical-Surgical Nurse Specialist in the domain of critical care. The ability to care for individuals and families encountering complex critical illness processes was a daily occurrence in the various internship fields. To achieve this, nurses must possess the knowledge to respond quickly and holistically to people in critical situations. The training provided was found to be a fundamental pillar for responding to the development of professional learning. Nurses in the emergency department must possess in-depth knowledge of the signs and symptoms suggestive of VVS activation, as they are the first health professionals to come into contact with the patient.
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Keywords
Sépsis Serviço hospitalar de emergência Conhecimento Enfermeiros