Turkiye Klinikleri Journal of Nursing Sciences

.: ORIGINAL RESEARCH
Yoğun Bakımda Basınç Yarası Gelişmş Hastaların Değerlendirilmesi
Evaluation of Cases with Pressure Ulcer in Intensive Care Unit
Onur AVCIa
aAnesteziyoloji ve Reanimasyon ABD, Sivas Cumhuriyet Üniversitesi Tıp Fakültesi,
Sivas, TÜRKİYE
Turkiye Klinikleri J Nurs Sci. 2019;11(3):239-45
doi: 10.5336/nurses.2018-64013
Article Language: TR
Full Text
ÖZET
 Amaç: Basınç yaraları; morbiditeyi, mortaliteyi ve hastanede yatış süresini artıran bir sağlık sorunudur. Bu çalışmada; kliniklerden ve acil servisten anestezi yoğun bakıma yatırılan hastalarda basınç yarası görülme sıklığını, oluşma sürecini, Waterlow risk skoru ile korelasyonunu, en sık basınç yarası gelişen bölgeleri ve diğer kliniklerde basınç yarası gelişen hasta sayısı ile anestezi yoğun bakımda basınç yarası gelişen hasta sayısının karşılaştırılması amaçlanmıştır. Gereç ve Yöntemler: Girişimsel olmayan klinik uygulamalar etik kurulu alındıktan sonra; anestezi yoğun bakım ünitesinde Mart 2013-Nisan 2016 tarihleri arasında, yatmakta olan 1.739 hastadan basınç yarası gelişen 201 hastada tanımlayıcı tipte, retrospektif, tek merkezli bir çalışma olarak planlandı. Çalışmamızda hastaların demografik bilgilerini, Waterlow risk skorlarını, basınç yarası evrelerini, anestezi yoğun bakıma devir alındıkları klinikleri ve basınç yarası oluşan bölgeleri içeren bir tanımlama formu kullanılmıştır. Bulguların değerlendirilmesinde SPSS Windows 22.0 programı kullanıldı. Bulgular: Yoğun bakım ünitesinde Mart 2013-Nisan 2016 tarihleri arasında basınç yarası gelişme oranı %11,55 olarak hesaplandı. Basınç yarası kaydı yapılan 201 hastanın %47,8?i erkek, %52,2?si ise kadın hasta idi. Ortalama Waterlow risk skoru 23,22 olarak hesaplandı. Basınç yarası oluşma süresi ise ortalama olarak 22,94 gün olarak bulundu. Yoğun bakım hastalarının (n=201) %28?inde evre 1, %52?sinde evre 2, %16?sında evre 3 ve %2,4?ünde evre 4 basınç yarası gelişmiştir. Yoğun bakıma kabul edilen ve basınç yarası gelişen hastaların kabul edildiği klinikler incelendiğinde, %40,8 ile dâhiliye kliniğinden gelen hastaların olduğu saptanmıştır. Bu hastalarda en sık olarak da sakrum ve koksiks bölgesinde basınç yarası geliştiği görülmüştür. Sonuç: Anestezi yoğun bakım ünitesinde basınç yarası gelişen hasta sayısının; kliniklerden kabul edilen basınç yarası tanısı almış hasta sayısına kıyasla anlamlı düzeyde yüksek olduğu saptanmıştır. Yoğun bakımda çalışan ekibin niteliklerinin artırılması, hizmet içi eğitimler, düzenli basınç yarası risk skoru analizi ve basınç yarası önleyici uygulamalarla basınç yarası oluşumunun önlenmesi önerilmektedir.

Anahtar Kelimeler: Basınç yarası; Waterlow risk skoru; yoğun bakım
ABSTRACT
 Objective: Pressure ulcer is a health problem that increases morbidity, mortality and duration of hospitalization. The aim of this study is to determine the frequency of pressure ulcers, average of pressure ulcer formation process, the correlation with Waterlow risk score, the most frequent locations of pressure ulcers, and to compare the number of patients with pressure ulcers inside and outside anesthesia intensive care units. Material and Methods: After approval of the ethics committee of non-interventional clinical practice were taken; 1.739 patients who were treated between March 2013-April 2016 in anesthesia intensive care unit were included in this definitive, retrospective, one-centered study. A definition form which includes demographic informations, Waterlow risk scores, pressure ulcer stages, clinics which the patients were taken to anesthesia intensive care unit and regions with pressure ulcers of the patients was used in this study. SPSS for Windows 22.0 program was used to evaluate findings from the research. Results: Between March 2013-April 2016, pressure ulcer occurrence rate was 11.55%. 201 patients with pressure ulcers 47.8% were male, 52.2% were female. Average Waterlow risk score was 23.22. Average time for pressure ulcer generation was 22.94 days. Of the 201 patients diagnosed with pressure ulcers in intensive care unit, 28% were stage 1, 52% were stage 2, 16% were stage 3 and 2.4% were stage 4. Between the patient group taken from another service, the patients that were taken from internal medicine had the most number of pressure ulcer diagnosis with 40.8%. The most common locations of pressure ulcers were sacrum and coccyx. Conclusion: The number of patients diagnosed with pressure ulcers in our anesthesia intensive care unit was found to be significantly higher than the number of patients that taken from clinics with pressure ulcer diagnosis. We suggest to prevent pressure ulcer occurrence with in-service trainings, more qualified medical staff in intensive care units, regular pressure ulcer risk score analysis and preventive applications.

Keywords: Pressure ulcer, Waterlow risk score, intensive care unit
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