Kolorektal Cerrahisinde Hızlandırılmış Bakım Protokolleri ve Hemşirelik Bakımı

Öz

Geleneksel uygulamalar sonucu hastaların hastanede yatma sürelerinin yüksek olması ve uzun süre hastanede kalmanın hastaların iyileşmelerini olumsuz yönde etkilemesi nedeniyle hastanede kalış sürelerini azaltmayı amaçlayan ve kanıta dayalı olan hızlandırılmış cerrahi protokolleri oluşturulmuştur. Bu protokoller ameliyat sonrası iyileşmeyi hızlandırmak için ortaya çıkmış kanıta dayalı bir bakım modelidir. Avrupa’da ameliyat sonrası iyileşmenin hızlandırılması anlamında “ERAS”, Amerika’da ise hızlandırılmış süreç anlamında “fast tract cerrahi” olarak adlandırılır. Hemşirelik bakımında kanıta dayalı bir bakımın verilmesi hemşireliğin gelişimine, yeni politikaların ve prosedürlerin kullanılmasına olanak sağlamaktadır. Bu derlemede kanıta dayalı bir uygulama olan kolon cerrahisi için ERAS protokollerinde hemşirelik yaklaşımları hemşirelerin fonksiyonlarının bulunduğu; preoperatif bilgilendirme, eğitim ve danışmanlık, preoperatif optimizasyon, tromboembolinin önlenmesi, ameliyat öncesi açlık süresi ve karbonhidrat tedavisi gibi bazı protokoller doğrultusunda ele alınmıştır. Sonuç olarak protokolde yer maddelerin çoğunda hemşirelik uygulamalarının yer aldığı saptanmıştır. Bununla birlikte kanıt temelli bir uygulama olan ERAS protokollerinin geleneksel uygulamalardan çok daha farklı bir uygulama olduğu görülmektedir. Bu nedenle hemşirelere ve hemşirelik öğrencilerine ERAS protokolleri hakkında bilgilendirme yapılması önerilmektedir. Ayrıca literatürde ülkemizde bu alana yönelik deneysel hemşirelik çalışmalarının az olduğu saptanmıştır. Hemşirelik bakımına yönelik deneysel çalışmaların artırılması önerilmektedir.

Anahtar Kelimeler

• ERAS Protokolleri, Kolorektal Cerrahisi, Hemşirelik Bakımı.

Enhanced Recovery After Surgery Protocols and Nursing Care for Colon Surgery

Öz

The protocols have been established to reduce the length of stay in hospitals, because they stay in hospitals for long times as a result of conventional applications, this condition adversely affects the healing of patients. It is called as "ERAS-Enhanced Recovery After Surgery" in Europe in the meaning of the acceleration of post-operative healing, "fast tract surgery" in US in the meaning of accelerated surgery and "Accelerated Care Protocols-HBP" in Turkey. Accelerated care protocols provide a evidence-based care in nursing care, allow the development of nursing and the use of new policies and procedures. Firstly, accelerated care protocols for colorectal surgery were discussed in this review due to the development of protocols for colorectal surgery and the difficulties in reaching the common items in the protocol. In this review, the roles of nurses in preoperative informing, training and counseling, the optimisation of the patient before the surgery which were included in the protocol, which cover the duties of the nurses were discussed. As a result, it was determined that nurses pactices take part in most of the items in the protocol. However, it seems that these protocols which are evidence-based applications are far different from traditional applications. Therefore, it is recommended to inform nurses and nursing students about this issue. In addition, it was determined that experimental nursing studies in this field in Turkey were few. For colorectal surgery, it is suggested to increase the number of experimental studies on the use of accelerated care protocols in nursing care.

Anahtar Kelimeler

• ERAS Protocols, Colorectal Surgery, Nursing Care

Kaynakça

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