A contenção mecânica na pessoa idosa em contexto hospitalar / Mechanical restraint in the elderly in a hospital context

A contenção mecânica pode ser definida como qualquer ação ou procedimento que impede os movimentos do corpo de uma pessoa através de qualquer método que lhe esteja adjacente ou anexado e que ela não consiga controlar ou remover facilmente. É uma medida que tem como objetivo otimizar a segurança do doente e de quem o rodeia, contudo a sua utilização é por vezes indevida, causando complicações físicas e psicológicas e comprometendo a dignidade, liberdade e autonomia das pessoas a ela submetidas. Alguns fatores de risco associados a uma maior predisposição para a colocação de medidas de contenção mecânica incluem a idade avançada, alterações cognitivas, incontinência e dependência nas atividades de vida diárias, tornando a população idosa particularmente vulnerável a ser submetida a estas medidas. Estes aspetos complexificam a tomada de decisão que no caso particular dos enfermeiros, é tida como um processo de deliberação ética que envolve a manutenção da integridade física, psicológica e moral da pessoa idosa. Deste modo, definiu-se como finalidade para este projeto contribuir para a melhoria dos cuidados de enfermagem à pessoa idosa submetida a contenção mecânica em contexto hospitalar. De forma a atingir esta finalidade e os objetivos propostos foram planeadas três atividades: a prestação de cuidados de enfermagem direta a pessoais idosas com fatores de risco para a contenção mecânica; a participação na elaboração e implementação do estudo de investigação com o objetivo estruturar um plano de melhoria que promova a segurança da pessoa idosa em risco de contenção mecânica em contexto hospitalar e a capacitação dos profissionais de saúde para a tomada de decisão em relação à utilização de medidas de contenção mecânica na pessoa idosa. Este relatório visa demonstrar o percurso realizado ao longo do estágio, que consistiu num processo de aprendizagem para a aquisição e desenvolvimento de competências especializadas, no que respeita às competências de enfermeiro mestre e especialista em enfermagem médico-cirúrgica.

Physical restraint can be defined as any action or procedure that impedes the movement of a person's body through any method that is adjacent or attached to it, and that the person cannot easily control or remove. It is a measure that aims to optimize patient's safety and those around him, however its use is at times inappropriate, causing physical and psychological complications and compromising the dignity, freedom and autonomy of the people subjected to it. Some risk factors associated with a greater predisposition to the placement of physical restraint measures include advanced age, cognitive alterations, incontinence and dependence in daily activities, making the elderly population particularly vulnerable to being subjected to these measures. These aspects complicate decision-making which, in the particular case of nurses, is seen as a process of ethical deliberation that involves maintaining the physical, psychological and moral integrity of the elderly patient. Thus, the purpose of this project was defined as contributing to the improvement of nursing care for the elderly subject to physical restraint in hospital context. In order to achieve this purpose and the proposed objectives, three activities were planned: the provision of direct nursing care to elderly people with risk factors for physical restraint; participation in the preparation and implementation of the research study with the goal of structuring an improvement plan that promotes the safety of the elderly at risk of physical restraint in the hospital context and training of health professionals to make decisions regarding the use of measures of physical restraint in the elderly. This report aims to demonstrate the path taken during the internship, which consisted of a learning process for the acquisition and development of specialized skills, with regard to the skills of master nurse and specialist in medical-surgical nursing.

How Computer-Assisted Learning Influences Medical Students' Performance in Anatomy Courses.

Anatomy is an essential subject of the medical curriculum. Despite its relevance, the curricular time and logistical resources devoted to teaching anatomy are in decline, favoring the introduction of new pedagogical approaches based on computer-assisted learning (CAL). This new pedagogical approach provides an insight into students' learning profiles and features, which are correlated with knowledge acquisition. The aim of this study was to understand how training with CAL platforms can influence medical students' anatomy performance. A total of 611 medical students attending Musculoskeletal Anatomy (MA) and Cardiovascular Anatomy (CA) courses were allocated to one of three groups (MA Group, CA Group, and MA + CA Group). An association between the performance in these anatomy courses and the number of CAL training sessions was detected. In the MA Group (r = 0.761, P < 0.001) and the MA + CA Group (r = 0.786, P < 0.001), a large positive correlation was observed between musculoskeletal anatomy performance and the number of CAL training sessions. Similarly, in the CA Group (r = 0.670, P < 0.001) and the MA + CA Group (r = 0.772, P < 0.001), a large positive correlation was observed between cardiovascular anatomy performance and the number of CAL training sessions. Multiple linear regression models were performed, considering either musculoskeletal or cardiovascular anatomy performance as the dependent variable. The results suggest that using CAL platforms to study has a positive dose-dependent effect on anatomy performance. Understanding students' individual features and academic background may contribute to the optimization of the learning process.