Yogun Bakimda Organizasyon, Yonetim ve Egitim

.: PREFACE
ÖN SÖZ
PREFACE
Prof. Dr. Volkan HANCI
Dokuz Eylül Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon ABD, Yoğun Bakım BD, İzmir
Article Language: TR
Yoğun bakım üniteleri, mevcut hastalıkları nedeni ile hayatı tehdit altında olan, bir ya da daha fazla organ veya organ sistemlerinde ciddi işlev bozukluğu gelişmiş hastaların iyileştirilmesini amaçlayan, yerleşim biçimi ve hasta bakımı açısından ayrıcalık taşıyan, ileri teknolojiye sahip cihazlarla donatılmış, 24 saat hayati fonksiyonların gözlendiği, hastaların kesintisiz olarak uzman bir ekip tarafından takip ve tedavi edildiği klinik birimlerdir. Durumları ağır olmakla beraber düzeltilebilir vakaların, ihtiyaç duyduğu monitörizasyon, bakım ve tedavilerin aynı serviste özel eğitilmiş personellerle yapılması sağlanır.

Primer hastalıkları geçinceye kadar vital fonksiyonlarından birinin ya da bir kaçının yapay olarak veya desteklerle sürdürülmesi gereken, sürekli monitörizasyon ihtiyacı olan, ağır metabolik ve elektrolit dengesizliği olan, özel ve yoğun bir hemşirelik bakımı gerektiren, letal komplikasyonlar oluşabilecek olan hastalar sıklıkla yoğun bakım ünitelerine kabul edilen hasta gruplarıdır. Bu hastaların tedavisi amacıyla uzman doktor, hemşire ve teknisyenler tarafından mekanik ventilatörler, monitörler, diyaliz cihazları, defibrilatör gibi ileri teknoloji aletler ve farmakolojik ajanlar kullanılır. Aynı zamanda bu hastalar, eşlik eden çok sayıdaki yandaş hastalıkları nedeniyle, sıklıkla hızlı değerlendirme ve hızlı tedavi planı değişikliklerine gerek duyulan vakalardır.

Oldukça komplike hâle gelmiş böyle bir sağlık hizmetinin her safhasında yeterli bilgi, beceri, deneyim, hasta güvenliğinin öncelenmesi ve iyi bir planlama gereklidir. Yoğun bakımda başarının anahtarlarından biri olan iyi bir planlamada ise, organizasyon ve yönetim becerilerinin bilinmesi ve edinilmesi gözden kaçırılmaması gereken bir gerçektir.

Ülkemizde yoğun bakım alanında çalışan değerli yazarlar grubumuzun yoğun katkıları ile oluşan bu kaynağımız, yoğun bakımın mimari organizasyonu, fiziki donanımı, yatak kullanımı, personel modelleri, hasta kabul ve taburculuk kriterleri, kaynak yönetimi, hasta ve çalışan güvenliği, yoğun bakım politikaları, takım çalışması, iletişim, eğitim, etik ve hukuksal sorunlar gibi kimi zaman gözden kaçabilen ancak yoğun bakım organizasyon ve yönetimi için önemli olan konularda değerli bilgiler sunmaktadır.

Özellikle güncel pandeminin, yoğun bakımların önemini ve değerini açıkça ortaya koyduğu günümüz şartlarında, yoğun bakımda pandemi ve salgın yönetimi, yoğun bakımda afet yönetimi, yoğun bakımda klinik bilgi - bilişim sistemleri ve bilgi teknolojilerinin yoğun bakım ünitesine entegrasyonu, yoğun bakımı uzaktan yönetme: Yoğun bakımda tele-tıp, yoğun bakım uzmanlık eğitiminde yeni yöntemler ve simülasyon eğitimi, yoğun bakımda çalışan güvenliği, yoğun bakım ünitesi personelinde tükenmişlik, bağımlılık, psikolojik destek, moral, refah ve motivasyon gibi pandemi döneminde öne çıkan konular da çalışmamızın içerisinde yer almaktadır.

Alanında tecrübeli hocalarımızın değerli katkıları ile, güncel literatür bilgilerinden yararlanılarak, özenle hazırlanan bu çalışmadaki kanıtlanmış bilgilerin, tüm meslektaşlarıma yararlı olacağını ve "Yoğun Bakım" alanındaki Türkçe literatüre katkıda bulunacağını düşünüyorum. Bu kitapta yer alan derlemeleri ben şahsen büyük bir zevk ve ilgi ile okudum, tüm okuyucuların da beklentileri karşılaması dileğiyle, yoğun bakım uygulayıcıları için yararlı bir kaynak olmasını dilerim. Çalışmamıza, mesleki açıdan yılların birikimine sahip değerli meslektaşlarımın yazar olarak katılması beni çok mutlu etmiştir. Kendilerine değerli katkılarından dolayı özellikle teşekkür ediyorum. Bu süreçte özveri ile çalışan ve çalışmamızın yayınlanması için zemin hazırlayan Türkiye Klinikleri ailesine de ayrıca teşekkürlerimi sunuyorum.

Saygılarımla.

Prof. Dr. Volkan HANCI
Editör


KAYNAK
1. Hancı V, Özbilgin Ş. Yoğun Bakım Hastalarında Rejyonel Anestezi/Analjezi uygulamaları. Turkiye Klinikleri J Anest Reanim-Special Topics. 2015;8(3):213-24.
Intensive care units are clinical units aiming to heal patients with severe function disorder in one or more organs or organ systems which is life-threatening due to disease. The units are specialized in terms of layout and patient care, equipped with advanced technology devices, observing vital signs over 24 hours with uninterrupted monitoring and treatment by an expert team. Cases with severe but correctable status have the required monitoring, care and treatment provided by specially-trained personnel in the same ward.

Patient groups admitted to intensive care units are frequently those requiring maintenance of one or more vital functions artificially or with support until primary disease ameliorates, requiring continuous monitoring, with severe metabolic and electrolyte imbalance, requiring special and intense nursing care, and where lethal complications may occur. With the purpose of treating these patients, specialist doctors, nurses and technicians use advanced technological tools like mechanical ventilators, monitors, dialysis devices, and defibrillators and pharmacological agents. Simultaneously, there are cases which require frequent rapid assessment and rapid treatment plan changes due to many comorbid diseases in these patients.

For such a complicated health service, every stage requires good planning and sufficient knowledge, skills, and experience prioritizing patient safety. One of the keys to the success of intensive care is good planning, while knowing and obtaining organizational and management skills is a reality that should not be ignored.

This reference presents valuable information about important topics in intensive care organization and management which may be ignored at times, with extensive contributions from our esteemed author group working in the intensive care field in our country. Topics include architectural organization of intensive care, physical equipment, bed use, personnel models, patient admission and discharge criteria, resource management, patient and employee safety, intensive care policies, team work, communication, education, ethics and legal problems.

Especially during the current pandemic clearly revealing the importance and value of intensive care in conditions today, our study includes topics which have come to the agenda during the pandemic period. These include pandemic and epidemic management in intensive care, natural disaster management in intensive care, clinical information-information systems in intensive care and integration of information technology with the intensive care unit, distant management of the intensive care, and tele-medicine in intensive care. In terms of intensive care employees, our study mentions new methods for training intensive care specialists and simulation training, employee safety in intensive care and burnout, addiction, psychological support, morale, welfare and motivation among personnel in the unit.

I believe that with the valuable contributions of our teachers experienced in the field, this carefully prepared study benefitting from current literature knowledge is full of proven information will benefit all our colleagues and contribute to the Turkish literature about intensive care. I personally read the reviews in this book with great enjoyment and interest, and with the hope of meeting expectations of all readers, my wish is that this will be a beneficial reference for intensive care practitioners. The participation of my esteemed colleagues with years of experience in professional terms as authors made me very happy. I thank them all individually for their valuable contributions. I also offer my gratitude to the Türkiye Klinikleri family working with devotion during this process and preparing the way for the publication of our work.

Respectfully.

Prof. Dr. Volkan HANCI
Editor


REFERENCE
1. Hancı V, Özbilgin Ş. Yoğun Bakım Hastalarında Rejyonel Anestezi/Analjezi uygulamaları. Turkiye Klinikleri J Anest Reanim-Special Topics. 2015;8(3):213-24.

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