scholarly journals Competências do enfermeiro para o cuidado paliativo em cardiologia

2018 ◽  
Vol 12 (9) ◽  
pp. 2341 ◽  
Author(s):  
Bruna Christine Floriano Brabo ◽  
Manoela Gomes Grossi Laprano
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
Intensive Care ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Structured Interview ◽  
Social Needs ◽  
Joint Decision ◽  
Multiprofessional Team ◽  
Terapia Intensiva

RESUMOObjetivo: analisar as competências profissionais do enfermeiro para o cuidado paliativo em Unidade de Terapia Intensiva Cardiológica. Método: estudo qualitativo, descritivo e exploratório fundamentado no referencial teórico das Competências Centrais em Cuidados Paliativos e realizado na UTI de um hospital cardiológico. Realizou-se a entrevista semiestruturada com oito enfermeiros. Para a interpretação dos dados, utilizaram-se a análise de conteúdo e a categorização. Resultados: prevaleceram enfermeiras de 31 a 41 anos, com mais de dez anos de experiência na profissão e com, ao menos, um curso de pós-graduação. As competências mais citadas estão relacionadas aos constituintes centrais dos cuidados paliativos, à família, ao autoconhecimento, ao desenvolvimento profissional e ao conforto físico. As categorias menos citadas retratam as necessidades psicológicas, espirituais, o trabalho em equipe, a comunicação e a tomada de decisão ética e clínica. Não houve relatos das necessidades sociais. As competências não aplicadas referem-se à atuação na equipe multiprofissional, à tomada de decisão conjunta e à educação dos profissionais e da família. Conclusão: prevaleceram citações de competências relacionadas à assistência. Após recente implantação do serviço, observa-se a necessidade do fortalecimento da equipe multiprofissional e da educação dos profissionais de Enfermagem. Descritores: Cuidados Paliativos; Competência Profissional; Cuidados Críticos; Enfermagem; Unidade de Terapia Intensiva; Cardiologia.ABSTRACT Objective: to analyze the professional competencies of the nurse for palliative care in the Cardiology Intensive Care Unit. Method: a qualitative, descriptive, exploratory study based on the theoretical reference of the Central Skills in Palliative Care and carried out at the ICU of a cardiological hospital. A semi-structured interview was conducted with eight nurses. For the interpretation of the data, the content analysis and the categorization were used. Results: nurses from 31 to 41 years old, with more than ten years of experience in the profession and with at least one postgraduate course prevailed. The most cited competences are related to the central constituents of palliative care, family, self-knowledge, professional development and physical comfort. The less-quoted categories portray psychological, spiritual, teamwork, communication, and ethical and clinical decision-making. There were no reports of social needs. The competences that were not applied, refer to the performance in the multiprofessional team, the joint decision making and the education of the professionals and the family. Conclusion: citations of competence related to care prevailed. After the recent implementation of the service, the need to strengthen the multiprofessional team and the education of nursing professionals is observed. Descritores: Palliative Care; Profissional Competence; Critical Care; Nursing; Intensive Care Units; Cardiology.RESUMEN Objetivo: analizar las competencias profesionales del enfermero para el cuidado paliativo en Unidad de Terapia Intensiva Cardiológica. Método: estudio cualitativo, descriptivo, exploratorio fundamentado en el referencial teórico de las Competencias Centrales en Cuidados Paliativos y realizado en la UTI de un hospital cardiológico. Se realizó la entrevista semiestructurada con ocho enfermeros. Para la interpretación de los datos, se utilizaron el análisis de contenido y la categorización. Resultados: prevalecieron enfermeras de 31 a 41 años, con más de diez años de experiencia en la profesión y con, al menos, un curso de postgrado. Las competencias más citadas están relacionadas a los constituyentes centrales de los cuidados paliativos, a la familia, al autoconocimiento, al desarrollo profesional y al confort físico. Las categorías menos citadas retratan las necesidades psicológicas, espirituales, el trabajo en equipo, la comunicación y la toma de decisión ética y clínica. No hubo informes de las necesidades sociales. Las competencias no aplicadas se refieren a la actuación en el equipo multiprofesional, a la toma de decisión conjunta y a la educación de los profesionales y de la familia. Conclusión: prevalecieron citaciones de competencias relacionadas a la asistencia. Después de la reciente implantación del servicio, se observa la necesidad del fortalecimiento del equipo multiprofesional y de la educación de los profesionales de Enfermería. Descritores: Cuidados Paliativos; Competencia Profissional; Cuidados críticos; Enfermería; Unidades de cuidados intensivos; Cardiología.   

scholarly journals Storytelling, Safeguarding, Treatment, and Responsibility: attributes of recovery in psychiatric intensive care units

2014 ◽  
Vol 11 (02) ◽  
pp. 105-118 ◽  
Author(s):  
Karleen Gwinner ◽  
Louise Ward
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Illness ◽  
Intensive Care ◽  
Lived Experience ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Review Of Literature ◽  
Psychiatric Distress ◽  
Nurse Knowledge

AbstractBackground and aimIn recent years, policy in Australia has endorsed recovery-oriented mental health services underpinned by the needs, rights and values of people with lived experience of mental illness. This paper critically reviews the idea of recovery as understood by nurses at the frontline of services for people experiencing acute psychiatric distress.MethodData gathered from focus groups held with nurses from two hospitals were used to ascertain their use of terminology, understanding of attributes and current practices that support recovery for people experiencing acute psychiatric distress. A review of literature further examined current nurse-based evidence and nurse knowledge of recovery approaches specific to psychiatric intensive care settings.ResultsFour defining attributes of recovery based on nurses’ perspectives are shared to identify and describe strategies that may help underpin recovery specific to psychiatric intensive care settings.ConclusionThe four attributes described in this paper provide a pragmatic framework with which nurses can reinforce their clinical decision-making and negotiate the dynamic and often incongruous challenges they experience to embed recovery-oriented culture in acute psychiatric settings.

Reversibility of Delirium in Palliative Care (DRAFT)

2018 ◽  
Author(s):  
Tiffany Shaw ◽  
Eric Prommer
Keyword(s):  
Risk Factors ◽  
Decision Making ◽  
Palliative Care ◽  
Clinical Case ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Factors Associated ◽  
Frequent Event ◽  
Study Intervention

Delirium is a frequent event in patients with advanced cancer. Untreated delirium affects assessment of symptoms, impairs communication including participation in clinical decision-making. This study used specific diagnostic criteria for delirium and prospectively identified precipitating causes of delirium. The study identified factors associated with reversible and irreversible delirium. Impact of delirium on prognosis was evaluated. This chapter describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case. Topics covered include delirium, neoplasms, palliative care, polypharmacy, risk factors, and therapeutics.

Creation of a palliative care advanced practice registered nurse peer-review process

2019 ◽  
Vol 25 (12) ◽  
pp. 596-602
Author(s):  
Patrice R. Fedel ◽  
Nicole E. Hembel ◽  
Lindsey M. Mueller
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
Peer Review ◽  
Professional Growth ◽  
Review Process ◽  
Clinical Decision Making ◽  
Peer Review Process ◽  
Clinical Decision ◽  
Advanced Practice ◽  
Case Review

The mark of a true profession is the ability to self-regulate. As such, advanced practice registered nurses (APRNs) are challenged by their professional organisations to participate in self-evaluation and peer review. Peer review is a method for evaluating the care provided by the APRN to both ensure quality nursing care and promote professional growth. Despite guidelines to participate in a formal peer-review process, there is little information within the nursing profession on how to accomplish peer review. A comprehensive literature review failed to provide a framework for peer review that is practice focused, fosters a learning environment and encompasses the thought process and clinical decision-making of the palliative care advanced practice nurse. A group of palliative care APRNs set out to create a process that encompassed the breadth of clinical decision-making in palliative care advanced nursing practice. Using the eight domains of palliative care, a narrative case review structure was created. The resulting process both assisted the APRNs in professional growth and provided timely feedback for the annual performance evaluation.

Clinical Decision Making in the ICU: Dysphagia Screening, Assessment, and Treatment

2019 ◽  
Vol 40 (03) ◽  
pp. 170-187 ◽  
Author(s):  
Martin B. Brodsky ◽  
Emily B. Mayfield ◽  
Roxann Diez Gross
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Clinical Decision Making ◽  
Clinical Care ◽  
Clinical Decision ◽  
Level Of Care ◽  
Assessment And Treatment ◽  
Proper Training ◽  
Screening Assessment

AbstractClinicians often perceive the intensive care unit as among the most intimidating environments in patient care. With the proper training, acquisition of skill, and approach to clinical care, feelings of intimidation may be overcome with the great rewards this level of care has to offer. This review—spanning the ages of birth to senescence and covering oral/nasal endotracheal intubation and tracheostomy—presents a clinically relevant, directly applicable review of screening, assessment, and treatment of dysphagia in the patients who are critically ill for clinical speech–language pathologists and identifies gaps in the clinical peer-reviewed literature for researchers.

scholarly journals The Role of C-Reactive Protein and the SOFA Score as Parameter for Clinical Decision Making in Surgical Patients during the Intensive Care Unit Course

PLoS ONE ◽  
2013 ◽  
Vol 8 (2) ◽  
pp. e55964 ◽  
Author(s):  
Zainna C. Meyer ◽  
Jennifer M. J. Schreinemakers ◽  
Paul G. H. Mulder ◽  
Ruud A. L. de Waal ◽  
Antonius A. M. Ermens ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Sofa Score ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Surgical Patients ◽  
C Reactive Protein ◽  
Reactive Protein

Ethical Issues for Neonatal Nurses

1998 ◽  
Vol 5 (3) ◽  
pp. 206-217 ◽  
Author(s):  
Kaye Spence
Keyword(s):  
Decision Making ◽  
Intensive Care ◽  
Ethical Decision ◽  
Clinical Decision Making ◽  
Ethical Decision Making ◽  
Ethical Issues ◽  
Response Rate ◽  
Clinical Decision ◽  
Neonatal Nurses ◽  
Ethical Decisions

This article examines the involvement of neonatal nurses in ethical issues, achieved through a survey of Australian neonatal nurses. The aim was to discover if nurses were involved in ethical decisions, to examine various categories of neonates and the concerns that nurses felt about them, and to determine the extent to which nurses saw themselves as advocates. A response rate of 65% was achieved from nurses in two states who worked in intensive care and special care nurseries. The findings show that nurses were more likely to be involved in clinical decision making than in ethical decision making, showed the greatest concern for infants who had an uncertain prognosis, and saw themselves as advocates for their patients. The issues surrounding these findings are examined.

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