Hekim ve Hemşirelerin Derin Ven Trombozu Profilaksisinde Mekanik Yöntem Kullanımları ve Belirleyicileri

Year 2023, , 253 - 259, 29.12.2023

Süleyman Altun Elif Akyüz

https://doi.org/10.5152/JANHS.2023.23446

Abstract

Amaç: Bu çalışma, hekim ve hemşirelerin derin ven trombozu profilaksisinde mekanik yöntem kullanımlarını ve belirleyici faktörleri saptamak amacıyla yapılmıştır.

Yöntemler: Çalışma Aralık 2020-Şubat 2021 tarihleri arasında gerçekleştirildi. Bu çalışmanın katılımcılarını Türkiye’de bir üniversite hastanesinin cerrahi ve dahiliye klinikleri ile yoğun bakım ünitelerinde çalışan 234 hekim ve 303 hemşire oluşturdu. Veriler araştırmacılar tarafından geliştirilen formlar kullanılarak toplandı ve tanımlayıcı istatistik olarak ortalama ve standart sapma, sayı ve yüzde dağılımları kullanılarak analiz edildi.

Bulgular: Hekim ve hemşirelerin en çok kullandığı mekanik yöntem antiembolik çoraplardı. Mekanik yöntemlerin kullanımını belirleyen faktörler klinikteki rutin uygulamalar, uygulama kolaylığı, hastanın kullanımına uygunluğu, klinikte cihaz/malzeme varlığı ve hekim tercihi idi. Hemşirelerin bir kısmı (%39,3) mekanik yöntemleri kullanırken güçlük yaşadıklarını bildirdi. Hemşirelerin yaşadıkları güçlükler; hastaların mekanik yöntem kullanımına bağlı uyum sorunları (%38,9), mekanik yöntemleri doğru uygulayamama (%27,9), değerlendirememe/izleyememe (%20,0) ve hastane prosedürlerinde sorun yaşama (%13,2) olarak belirlendi. Hekimler, mekanik yöntemlerin yanlış/eksik kullanıldığını fark ettiklerini bildirdi (%57,7). Bu yanlış/eksik kullanımlar mekanik yöntemlerin yanlış uygulanması (%54,1) ve hastalara doğru mekanik yöntemin seçilememesiydi (%22,5).

Sonuç: Kliniklerde kılavuzlar dikkate alınarak hastaya uygun etkili ve güvenli mekanik yöntemler kullanılmalıdır. Bakımı standardize etmek için mekanik yöntemlerin kullanımına yönelik bakım protokolleri geliştirilmeli, kaliteli bakım sağlamak için sağlık profesyonellerine bu doğrultuda eğitim verilmelidir.

Physicians’ and Nurses’ Use and Determinants of Mechanical Methods for Prophylaxis of Deep-Vein Thrombosis

Abstract

Objective: This study was conducted to determine the use of mechanical methods and determining factors of prophylaxis of deep-vein thrombosis by physicians and nurses.

Methods: The study was conducted between December 2020 and February 2021. The participants of this study consisted of 234 physicians and 303 nurses working in surgical and internal medicine clinics/intensive care units of a university hospital in Turkey. Data were collected using forms developed by the researchers and analyzed using mean and standard deviation, number and percentage distributions as descriptive statistics.

Results: The mechanical method most used by the physicians and nurses was anti-embolism stockings. Factors determining the use of mechanical methods were routine practices in the clinic, ease of application, suitability for the patient use, presence of devices/materials in the clinics, and preference of the physician. Some of the nurses reported that they had difficulties using mechanical methods (39.3%). These difficulties were as follows: patients’ compliance problems related to the use of mechanical methods (38.9%), inability to apply mechanical methods correctly (27.9%), inability to evaluate/monitor it (20.0%), and having trouble with hospital procedures (13.2%). Physicians noticed the wrong/missing use of mechanical methods (57.7%). These were improper application of the mechanical methods (54.1%) and failure to choose the right mechanical method for the patients (22.5%).

Conclusion: Considering the guidelines, effective and safe mechanical methods suitable for the patient should be used in clinics. Care protocols should be developed for the use of mechanical methods to standardize care, and health professionals should be trained to provide quality care.

Keywords

Deep-vein thrombosis, mechanical methods, prophylaxis, physician, nurse

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