Turkiye Klinikleri Journal of Nursing Sciences

.: ORIGINAL RESEARCH
Yoğun Bakım Hemşirelerinin Entübe Hastalara Uyguladığı Ağız Bakımı Girişimlerine Yönelik Bilgi ve Uygulamalarının İncelenmesi: Tanımlayıcı-Gözlemsel Araştırma
Investigation of Knowledge and Practices of Intensive Care Nurses on Oral Care in Interventions Applied to Intubated Patients: Descriptive-Observational Research
Selma BAYRAKa, Semiha AKINb
aİstanbul Üniversitesi-Cerrahpaşa Cerrahpaşa Tıp Fakültesi, İstanbul, Türkiye
bSağlık Bilimleri Üniversitesi Hamidiye Hemşirelik Fakültesi, İç Hastalıkları Hemşireliği ABD, İstanbul, Türkiye
Turkiye Klinikleri J Nurs Sci. 2022;14(3):848-60
doi: 10.5336/nurses.2021-87261
Article Language: TR
Full Text
ÖZET
 Amaç: Bu araştırma, yoğun bakım hemşirelerinin entübe hastalarda ağız bakımına yönelik bilgi ve uygulamalarının incelenmesi amacıyla gerçekleştirildi. Gereç ve Yöntemler: Bu çalışma tanımlayıcı-gözlemsel özellikte bir araştırmadır. Araştırma evrenini 130 hemşire, örneklemi üniversite hastanesinin 5 erişkin yoğun bakım biriminde en az 6 aydır çalışan 105 hemşire oluşturdu. Veriler anket ve gözlem yöntemiyle 'entübe hastalarda özel ağız bakımı uygulamaları gözlem formu' ile 'entübe hastalarda ağız bakımı uygulamalarına ilişkin bilgi formu' kullanılarak toplandı. Bulgular: Ortalama yaş değeri 28,68±6,18 yıl olan örneklemin %72,4'ü lisans mezunudur ve yoğun bakım ünitesinde çalışma süresi 60,86±66,70 ay olarak saptandı. Yoğun bakım hemşirelerinin ağız bakımı bilgi puanları yüksek (13,48±2,07) düzeyde bulundu. Gözlem formu puan ortalama değeri, hemşirelerin yoğun bakım hastalarına ağız bakımı uygulama becerilerini orta düzeyde yeterli (12,86±2,65; medyan 13) olduğunu gösterdi. Hemşirelerin ağız bakımına ilişkin genel ilkeleri iyi yaptıkları gözlenirken özellikle entübasyona yönelik adımları uygulamada çok yeterli olmadığı saptandı. Yoğun bakım hemşireliği sertifikasına sahip olan katılımcıların entübe hastalarda ağız bakımına ilişkin bilgi düzeyi ve uygulama becerileri puanları daha yüksek bulundu (p=0,002). Ağız bakımına ilişkin bilgi ile gözlem formu puanları arasında istatistiksel olarak anlamlı ilişki saptanmadı (p>0,05). Sonuç: Yoğun bakım hemşirelerinin ağız bakımı konusundaki bilgi ve uygulamalarının teorik ve uygulamalı eğitimler ile güncellenmesi gerekir. Entübe hastaları için kanıta dayalı standart bir ağız bakım protokolünün oluşturulmalı ve uygulamaya yansıtılması konusunda teşvik edilmelidir. Yoğun bakım hemşirelerinin yoğun bakımda ağız bakımı sırasında uygun pozisyonun verilmesi, entübe hastada tüp bakımı, kaf basıncı kontrolü ve aspirasyon uygulaması konusundaki becerilerinin geliştirilmesi önemlidir.

Anahtar Kelimeler: Ağız bakımı; bilgi; entübe hasta; hemşirelik; yoğun bakım
ABSTRACT
 Objective: This study was conducted to examine information and applications of intensive care nurses on intubated patients towards oral care. Material and Methods: The study was a descriptive-observational study. Research population of the study consisted of 130 nurses and the sample consisted of 105 nurses working in 5 adult intensive care units of a university hospital for at least 6 months. Data were collected using a questionnaire and observation method using the 'special oral care practices observation form for intubated patients' and the 'information form on oral care practices in intubated patients'. Results: The mean age of the sample was 28.68±6.18 years and 72.4% of the sample had a bachelor's degree and the years of experience in the intensive care unit was 60.86±66.70 months. Oral care information scores of intensive care nurses were determined to be high (13.48± 2.07). In this study, the mean score of the observation form showed that the nurses' ability to administer oral care to intensive care patients was moderately sufficient (12.86±2.65; median 13). The nurses were observed to perform the general principles of oral care efficiently; however, the nurses' skills for applying the steps for intubation were insufficient. Participants with an intensive care nursing certificate received higher scores from oral care information and practice skills on intubated patients (p=0.002). No statistically significant correlation was found between information about oral care and observation form scores (p>0.05). Conclusion: It is crucial to develop the skills of intensive care nurses in providing the appropriate position during oral care in the intensive care unit, tube care in the intubated patient, cuff pressure control, and aspiration practice.

Keywords: Oral care; knowledge; intubated patient; nursing; intensive care
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