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Bir kamu rehabilitasyon hastanesindeki inme vakalarının bası yarası oranları ve hemşirelerin bası yarası eğitim oranları

Year 2019, Volume: 3 Issue: 7, 512 - 514, 29.07.2019
https://doi.org/10.28982/josam.593148

Abstract

Amaç: İnme, her yıl dünyadaki milyonlarca insanı etkileyen ve yeti yitimine neden olan bir beyin damar hastalığıdır. İnme sonrası komplikasyonların hastanede kalmayı ve hasta bakım maliyetlerini arttırdığı bilinmektedir. İnme komplikasyonlarından biri olan bası yaraları bakım verenin eğitimi ile önlenebilir. Bu çalışmanın amacı bir kamu rehabilitasyon hastanesinde inme nedeniyle yatarak rehabilitasyon gören hastaların bası yarası oranlarını ve hemşirelere yönelik verilen bası yarası eğitim oranlarını araştırmaktır.

Yöntemler: Çalışmamız gözlemsel bir çalışmadır. 3 yıl boyunca (01.01.2016-31.12.2018), hastanemizde yatarak inme tedavisi gören hastaların dosyaları retrospektif olarak taranarak veriler toplanmıştır. Hemşire eğitimleri için eğitim birim kayıtları kullanılmıştır. İstatistiksel analiz olarak yüzde hesaplamaları kullanılmıştır.

Bulgular: Hastanemizde yatan toplam 3640 hastanın 1776’sı inme (%48,80) olarak saptanmıştır. Yatan akut inmeli hasta sayısı 1216 (%68,47) olarak bulunmuştur. Hastaların yattığı ortalama gün sayısı ise 27,6 gün olarak saptanmıştır. Hastaların demografik özelliklerine bakıldığında yatan hastaların 1005’i erkek (%56,59), 771’i kadın (%43,41) olup cinsiyete göre yaş ortalamasına bakıldığında erkek hastaların yaş ortalaması 64,18 olarak saptanırken kadın hastaların yaş ortalaması 68,78 olarak saptanmıştır. İnme risk faktörlerine bakıldığında hastanemizde yatan hastaların %59,74’ünde hipertansiyon (HT), %25,16’sında diyabetes mellitus (DM), %13,56’sında hiperlipidemi (HL), %15,03’ünde ise kardiyak hastalık,%6,41’inde üriner enfeksiyon, %3,71’inde pulmoner enfeksiyon, %0,5’inde derin ven trombozu, %0,56’sında ise malignite mevcuttur. Yatış esnasında bası yarası olan inmeli hasta sayısına bakıldığında 123 (%6,92) olarak tespit edilmiş olup, yatış sırasında yeni oluşan bir bası yarasına rastlanmamıştır. İnme tanısı almış bası yaralı hastaların hastanede yatan toplam bası yarası olan hasta sayısına oranına bakıldığında %32,97olarak bulunmuştur. Bası yarasına en sık rastlanan anatomik lokalizasyon sakrum 65 (%52,84) olurken, en az rastlanan lokalizasyon ise 1 hasta (%0,81) ile dirsek bölgesi olmuştur. Hemşirelere verilen bası yarası eğitimleri yılda 2 adet olup eğitime katılan hemşire oranı %71,5 olarak saptanmıştır. Refakatçilere verilen bası yarası eğitim sayısı yılda 12 adet olup eğitime katılım oranı %57,3 olmuştur.

Sonuç: İnme hastalarında bası yarası görülme oranı %6,92 olarak saptanmış olup, en sık lokalizasyon sakrum olarak bulunmuştur. Hastanede açılan yeni bası yarası oranının sıfır olması, rehabilitasyon hastanesinin bası yarası ile ilgili gerekli farkındalığın ve hemşire, refakatçi eğitim düzeyinin oluştuğunu göstermektedir.

References

  • 1. GBD 2016 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017 Sep 16;390(10100):1260-1344. doi: 10.1016/S0140-6736(17)32130-X.
  • 2. Saxena S, Ng T, Yong D, Fong N, Gerald K. Total direct cost, length of hospital stay, institutional discharges and their determinants from rehabilitation settings in stroke patients. Acta Neurol Scand. 2006;114(5):307–14.
  • 3. European Pressure Ulcer Advisory Panel (EPUAP) and National Pressure Ulcer Advisory Panel (NPUAP). Prevention of Pressure Ulcers: Quick Reference Guide. NPUAP, 2009.
  • 4. Doshi VS, Say JH, Young SH, Doraisamy P. Complications in stroke patients: a study carried out at the Rehabilitation Medicine Service, Changi General Hospital. Singapore Med J. 2003;44:643–52.
  • 5. Davenport RJ, Dennis MS, Wellwood I, Warlow CP. Complications after acute stroke. Stroke. 1996;27:415–20.
  • 6. Sackley C, Brittle N, Patel S, Ellins J, Scott M, Wright C, Dewey ME. The prevalence of joint contractures, pressure sores, painful shoulder, other pain, falls, and depression in the year after a severely disabling stroke. Stroke. 2008 Dec;39(12):3329-34. doi: 10.1161/STROKEAHA.108.518563.
  • 7. Özdemir G, Eken A. Yoğun Bakım Hemşirelerinin Bası Yarası Hakkındaki Bilgi Düzeylerinin Belirlenmesi. Boğaziçi Tıp Dergisi. 2018;5(1):23-7. Doi: 10.15659/bogazicitip.18.04.772.
  • 8. Amir Y, Halfens RJG, Lohrmann C, Schols J MGA. Pressure ulcer prevalence and quality of care in stroke patients in an Indonesian hospital. Journal of Wound Care. 2013;22(5):254–60. doi: 10.12968/jowc.2013.22.5.254

Pressure ulcer rates of stroke patients in a public rehabilitation hospital and training rates of nurses for pressure ulcer

Year 2019, Volume: 3 Issue: 7, 512 - 514, 29.07.2019
https://doi.org/10.28982/josam.593148

Abstract

Aim: Stroke is a brain vascular disease that affects millions of people in the world every year and causes disability. Complications following a stroke are known to increase hospital stay and patient care costs. A complication of stroke, pressure ulcer, can be avoided with education of the caregiver. That is why we aimed to investigate the rates of pressure ulcers of patients who were hospitalized in a public rehabilitation hospital because of stroke. Secondary aim of this study is to investigate the in-service trainings of the nurses about pressure ulcers.

Methods: This is an observational study. The files of inpatient stroke cases were retrospectively analyzed for dates between 01/01/2016 and 12/31/2018 and the data were collected. Education service files are analyzed for in-service trainings about pressure ulcers. Percentages were calculated for statistical analysis.

Results: Of the 3640 patients hospitalized in our hospital, 1776 had stroke (48.80%). The number of patients with acute stroke was 1216 (68.47%). The mean number of days of hospitalization was 27.6 days. When the demographic characteristics of the patients were examined, 1005 of the inpatients were male (56.59%), 771 were female (43.41%). The mean age of the male patients was 64.18 and the mean age of the female patients was 68.78 respectively. When the risk factors for stroke were examined, 59.74% of the hospitalized patients had hypertension (HT), 25.16% had diabetes mellitus (DM), 13.56% had hyperlipidemia (HL), 15.03% had cardiac disease, 6.41% had urinary infection, 3.71% had pulmonary infection, 0.5% had deep vein thrombosis, and 0.56% had malignancy. When the rate of pressure ulcers were examined, the number of stroke patients with pressure ulcers was 123 (6.92%) and no new pressure ulcers were observed during hospitalization. The rate of stroke patients with pressure ulcers among all pressure ulcer patients was calculated as 32.97%. The most common anatomic localization was sacrum 65 (52.84%) while the least common localization was elbow region with 1 patient (0.81%). The in-service trainings given to the nurses for pressure ulcers were 2 per year and the rate of nurses attending the training was determined as 71.5%. The number of trainings for medical companions was 12 per year and the participation rate to the training was 57.3%.

Conclusion: The incidence of pressure ulcers in stroke patients was determined as 6.92% and the most frequent localization was sacrum. The fact that the rate of new pressure ulcer opened in the hospital is zero indicates that in-service training and awareness about pressure ulcers in the rehabilitation hospital is sufficient.

References

  • 1. GBD 2016 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017 Sep 16;390(10100):1260-1344. doi: 10.1016/S0140-6736(17)32130-X.
  • 2. Saxena S, Ng T, Yong D, Fong N, Gerald K. Total direct cost, length of hospital stay, institutional discharges and their determinants from rehabilitation settings in stroke patients. Acta Neurol Scand. 2006;114(5):307–14.
  • 3. European Pressure Ulcer Advisory Panel (EPUAP) and National Pressure Ulcer Advisory Panel (NPUAP). Prevention of Pressure Ulcers: Quick Reference Guide. NPUAP, 2009.
  • 4. Doshi VS, Say JH, Young SH, Doraisamy P. Complications in stroke patients: a study carried out at the Rehabilitation Medicine Service, Changi General Hospital. Singapore Med J. 2003;44:643–52.
  • 5. Davenport RJ, Dennis MS, Wellwood I, Warlow CP. Complications after acute stroke. Stroke. 1996;27:415–20.
  • 6. Sackley C, Brittle N, Patel S, Ellins J, Scott M, Wright C, Dewey ME. The prevalence of joint contractures, pressure sores, painful shoulder, other pain, falls, and depression in the year after a severely disabling stroke. Stroke. 2008 Dec;39(12):3329-34. doi: 10.1161/STROKEAHA.108.518563.
  • 7. Özdemir G, Eken A. Yoğun Bakım Hemşirelerinin Bası Yarası Hakkındaki Bilgi Düzeylerinin Belirlenmesi. Boğaziçi Tıp Dergisi. 2018;5(1):23-7. Doi: 10.15659/bogazicitip.18.04.772.
  • 8. Amir Y, Halfens RJG, Lohrmann C, Schols J MGA. Pressure ulcer prevalence and quality of care in stroke patients in an Indonesian hospital. Journal of Wound Care. 2013;22(5):254–60. doi: 10.12968/jowc.2013.22.5.254
There are 8 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Research article
Authors

Başak Bilir Kaya 0000-0002-9586-9547

Publication Date July 29, 2019
Published in Issue Year 2019 Volume: 3 Issue: 7

Cite

APA Bilir Kaya, B. (2019). Pressure ulcer rates of stroke patients in a public rehabilitation hospital and training rates of nurses for pressure ulcer. Journal of Surgery and Medicine, 3(7), 512-514. https://doi.org/10.28982/josam.593148
AMA Bilir Kaya B. Pressure ulcer rates of stroke patients in a public rehabilitation hospital and training rates of nurses for pressure ulcer. J Surg Med. July 2019;3(7):512-514. doi:10.28982/josam.593148
Chicago Bilir Kaya, Başak. “Pressure Ulcer Rates of Stroke Patients in a Public Rehabilitation Hospital and Training Rates of Nurses for Pressure Ulcer”. Journal of Surgery and Medicine 3, no. 7 (July 2019): 512-14. https://doi.org/10.28982/josam.593148.
EndNote Bilir Kaya B (July 1, 2019) Pressure ulcer rates of stroke patients in a public rehabilitation hospital and training rates of nurses for pressure ulcer. Journal of Surgery and Medicine 3 7 512–514.
IEEE B. Bilir Kaya, “Pressure ulcer rates of stroke patients in a public rehabilitation hospital and training rates of nurses for pressure ulcer”, J Surg Med, vol. 3, no. 7, pp. 512–514, 2019, doi: 10.28982/josam.593148.
ISNAD Bilir Kaya, Başak. “Pressure Ulcer Rates of Stroke Patients in a Public Rehabilitation Hospital and Training Rates of Nurses for Pressure Ulcer”. Journal of Surgery and Medicine 3/7 (July 2019), 512-514. https://doi.org/10.28982/josam.593148.
JAMA Bilir Kaya B. Pressure ulcer rates of stroke patients in a public rehabilitation hospital and training rates of nurses for pressure ulcer. J Surg Med. 2019;3:512–514.
MLA Bilir Kaya, Başak. “Pressure Ulcer Rates of Stroke Patients in a Public Rehabilitation Hospital and Training Rates of Nurses for Pressure Ulcer”. Journal of Surgery and Medicine, vol. 3, no. 7, 2019, pp. 512-4, doi:10.28982/josam.593148.
Vancouver Bilir Kaya B. Pressure ulcer rates of stroke patients in a public rehabilitation hospital and training rates of nurses for pressure ulcer. J Surg Med. 2019;3(7):512-4.