Cerrahi yoğun bakım ünitelerinde yatan hastaların basınç yarası riski ve etkileyen faktörlerin belirlenmesi
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2022
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Bu araştırma cerrahi yoğun bakım ünitelerinde yatan hastaların, basınç yarası riski ve etkileyen faktörlerin belirlenmesi amacı ile tanımlayıcı olarak yapıldı. Araştırma, İstanbul Üniversitesi İstanbul Tıp Fakültesi Hastanesi' sindeki cerahi yoğun bakım ünitelerinde en az 24 saat yatan 152 hasta ile yapıldı. Araştırma verileri 25.12.2021- 09.08.2021 tarihleri arasında toplandı. Araştırma verileri, 'Hasta Tanıtım Formu', 'Braden Risk Değerlendirme Ölçeği' ve 'Glaskow koma Skalası' kullanılarak elde edildi. Hastalardan elde edilen verilerin istatistiksel analizleri SPSS (Statistical Packet for The Social Science) 25.0 paket programında yapıldı. Verilerin analizinde tanımlayıcı istatikler (sayı, yüzde, ortalama, standart sapma) ve Mann-Whitney U, Kruskall Wallis varyans analizi, Ki kare testler ve lojistik regresyon analizi kullanıldı. Hastaların yaş ortalaması 52.91±17.27, %53,3'ünün erkek, %65,1'inin evli, cerrahi işlem süresi ortalamasının 4.27±1.75 olduğu belirlendi. Araştırma kapsamına alınan hastaların %32,2'sinin kalp damar cerrahi yoğun bakım ünitesinde yattığı, %71,1'i kronik hastalığa sahip olduğu, %63,8'i oral beslenmekte, %51'inin cilt tipi normal, %63,8'i hareketlerinde yarı bağımlı ve %69'unun yoğun bakım sürecinde ventilatöre bağlanmadığı belirlendi. Hastaların 24., 48., 72. ve 120. saatlerde Braden Risk Değerlendirme Ölçeğinden aldıkları puan ortalamalarının sırasıyla; 13.12±3.91, 13.05±2.95, 12.03±3.36 ve 10.15±3.74 olduğu görüldü. Hastaların %20,6' sında basınç yarası geliştiği saptandı. Hastanın yaşı, cerrahi işlem süresi, kronik hastalık varlığı, ventilatöre bağlanma durumu, cilt özelliği, hareketlilik durumu, glaskow koma skalası aldığı puan ile basınç yarası oluşumu arasında istatistksel olarak anlamlı fark olduğu saptandı (p<0.001). Ameliyat sonrası laboratuvar bulgularından albümin (p<0.001), hemoglobin (p<0.001), kreatinin (p<0.001), lökosit (p<0.001), üre (p<0.001) ve total protein (p<0.005) değerleri ile basınç yarası oluşumu arasında istatistiksel olarak anlamlı ilişki olduğu belirlendi. Regresyon analizinde hemoglobin, total protein değerlerinin, ventilatöre bağlanma durumunun, cilt tipinin hassas ve nemli olmasının basınç yarası oluşmasını artmasına neden olduğu belirlendi. Cerrahi yoğun bakım hemşireleri hastalarında basınç yarası riskleri belirlemeli, bireye özgü hemşirelik bakımı planlarken, basınç yarası gelişimini arttıran faktörleri dikkate almalıdırlar.
This study was conducted as a descriptive study in order to determine the risk of pressure ulsers and their affecting factors on patients who were hospitalized in surgical intensive care units. The researchwas carried out with 152 patients who were hospitalized over 24 hours in the surgical intensive care units of Istanbul University Istanbul Medikal Faculty Hospital between the dates of 25.12.2020- 09.08.2021. Research data were obtained using the 'Patient Description Form', 'Braden Risk Assessment Scale' and 'Glaskow Coma Scale'. Statistical analyzes of the data, witch were obtained from the patients, were performed in SPSS (Statistical Packet for The Social Science) 25.0 package program. Descriptive statistics (number, percentage, mean, standard deviation) and Mann-Whitney U, Kruskal Wallis analysis of variance Chi-square tests and logistic regression analysis were used in the analysis of the data. It was determined that the mean age of the patients was ortalaması 52.91±17.27, 53,3% were male, 65,1% were married, and the mean duration of the surgical procedure was 4.27±1.75. It was determined that the patients who were included in the study, 32,2% of them were hospitalized in the cardiovascular surgery intensive care unit, 71,1% of them had chronic disease, 63,8% of them were fed orally, 51% of them had normal skin type, 63,8% of them were semi-dependent in their movements and 69% of them was not connected to the ventilator during the intensive care unit. The mean scores of the patients at the 24th, 48th, 72nd and 120th hours, from the Braden Risk Assessment Scale are respecvitely; 13.12±3.91, 13.05±2.95, 12.03±3.36 ve 10.15±3.74. Pressure ulcers were detected in 20,6% of the patients. A statistically significant difference was found between the patient's age, duration of the surgical procedure, presence of chronic disease, ventilator connection status, skin characteristics, mobility status, glaskow koma score and pressure ulcer formation. It was determined that there was a significant correlation between the postoperative laboratory findings of albumin, hemoglobin, creatinine, leukocyte, urea and total protein values and the formation of pressure sores. In the regression analysis, it was determined that hemoglobin, total protein values, ventilator attachment status, sensitive and moist skin type increased the formation of pressure ulcers. Surgical intensive care nurses should determine the risks of pressure ulcers in their patients and while planning individualnursing care, they should consider the factors that increase pressure ulcer development.
This study was conducted as a descriptive study in order to determine the risk of pressure ulsers and their affecting factors on patients who were hospitalized in surgical intensive care units. The researchwas carried out with 152 patients who were hospitalized over 24 hours in the surgical intensive care units of Istanbul University Istanbul Medikal Faculty Hospital between the dates of 25.12.2020- 09.08.2021. Research data were obtained using the 'Patient Description Form', 'Braden Risk Assessment Scale' and 'Glaskow Coma Scale'. Statistical analyzes of the data, witch were obtained from the patients, were performed in SPSS (Statistical Packet for The Social Science) 25.0 package program. Descriptive statistics (number, percentage, mean, standard deviation) and Mann-Whitney U, Kruskal Wallis analysis of variance Chi-square tests and logistic regression analysis were used in the analysis of the data. It was determined that the mean age of the patients was ortalaması 52.91±17.27, 53,3% were male, 65,1% were married, and the mean duration of the surgical procedure was 4.27±1.75. It was determined that the patients who were included in the study, 32,2% of them were hospitalized in the cardiovascular surgery intensive care unit, 71,1% of them had chronic disease, 63,8% of them were fed orally, 51% of them had normal skin type, 63,8% of them were semi-dependent in their movements and 69% of them was not connected to the ventilator during the intensive care unit. The mean scores of the patients at the 24th, 48th, 72nd and 120th hours, from the Braden Risk Assessment Scale are respecvitely; 13.12±3.91, 13.05±2.95, 12.03±3.36 ve 10.15±3.74. Pressure ulcers were detected in 20,6% of the patients. A statistically significant difference was found between the patient's age, duration of the surgical procedure, presence of chronic disease, ventilator connection status, skin characteristics, mobility status, glaskow koma score and pressure ulcer formation. It was determined that there was a significant correlation between the postoperative laboratory findings of albumin, hemoglobin, creatinine, leukocyte, urea and total protein values and the formation of pressure sores. In the regression analysis, it was determined that hemoglobin, total protein values, ventilator attachment status, sensitive and moist skin type increased the formation of pressure ulcers. Surgical intensive care nurses should determine the risks of pressure ulcers in their patients and while planning individualnursing care, they should consider the factors that increase pressure ulcer development.
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Hemşirelik, Basınç ülserleri, Hasta bakımı, Nursing, Hemşirelik bakımı, Pressure ulcer, Patient care, Yatan hastalar, Nursing care, Yoğun bakım, Inpatients, Intensive care, Yoğun bakım üniteleri, Intensive care units