Jinekolojik Onkoloji Cerrahisinde ERAS (Enhanced Recovery After Surgery) Protokolü Doğrultusunda Hemşirelik Yaklaşımları

Year 2024, Volume: 10 Issue: 1, 27 - 42, 30.03.2024

Minel Akten Yılda Arzu Aba

Abstract

Teknolojinin gün geçtikçe ilerlemesi ile yaşanan gelişmeler sağlık hizmetlerini de etkileyen sonuçları ortaya koymaktadır. Bilimsel araştırmalar ile elde edilen bilgilerin klinik uygulamalara aktarılması ile cerrahi alanda kanıta dayalı yaklaşımların önemini artırmıştır. ERAS (Enhanced Recovery After Surgery) bu yaklaşımlar arasında yer alan cerrahi tedavi alan bireylerin yaşam kalitelerini etkileyen önemli bir protokoldür. Primer hedefi hastalar üzerinde erken iyileşmeyi sağlayarak taburculuk süresini kısaltmak ve oluşabilecek komplikasyonları önlemektir. Kısaca ERAS protokolleri klinik sonuçları ve cerrahi sonrasında uygulanan bakımın kalitesini iyileştirmeyi hedefleyen yenilikçi uygulamalardır. ERAS protokolü günümüzde anestezi-analjezi, cerrahi yanıtın azaltılması, hidrasyonun sağlanması minimum düzeyde invaziv cerrahi, erken süreçte oral beslenme ve mobilizasyon alanlarında en kısa sürede iyileşmeyi ve hastalanma oranlarını en aza indirgemeyi hedeflemektedir. ERAS protokolü, ilk olarak Danimarka'da abdominal kolorektal cerrahi uygulamalarında başarıyla kullanılmış ve bu başarı, diğer cerrahi alanlarda da uygulanma gerekliliğini doğurmuştur. ERAS Jinekolojik/Onkolojik cerrahi protokolü ilk kez Şubat 2016’da yayınlanmış ve bu protokol 2019 yılında en güncel kanıtlara dayalı perioperatif bakım protokolü olarak ilk güncellemesini almıştır. Son güncellemesi ise 2023 yılında yapılmıştır. Bu derlemede ERAS Derneği (Enhanced Recovery After Surgery Society for Perioperative Care) tarafından hazırlanan ve 2023 yılında revize edilen ERAS protokolü doğrultusunda cerrahi öncesi, sırası ve sonrasında yapılması gereken yaklaşımlar ele alınmıştır. Bu doğrultuda, hemşirelerin jinekolojik onkoloji cerrahisi alanında bakım verirken ERAS protokollerinden yararlanması ve hemşirelik literatürüne yeni bir bakış açısı kazandırılması amaçlanmaktadır.

Keywords

ERAS protokolleri, hemşirelik, jinekolojik onkolojik cerrahi

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