Deliryumun Önlenmesinde Çok Bileşenli Farmakolojik Olmayan Hemşirelik Müdahaleleri

Abstract

Deliryum ani başlangıçlı, gün içerisinde dalgalanan bir dikkat seyri ve düşünce ve/veya davranış değişiklikleri ile karakterize bir durumdur. Altta yatan tıbbi durumla ilişkili olmakla birlikte yoğun bakım ünitelerinde yatan hastalarda sıklıkla görülmektedir. Yoğun bakımdaki hastada deliryumun ortaya çıkması hastanede kalış süresini, tedavi maliyetlerini olumsuz etkilemekte, hastanın bilişsel ve fonksiyonel işlevselliğini azaltmakta ve mortalite insidansını arttırmaktadır. Yoğun bakım ünitelerine bakım ve tedavi amacı ile kabul edilen hastada çok boyutlu bir değerlendirme yapan hemşireler, deliryum gelişiminde etkisi olan risk faktörlerinin iyileştirilmesinde kanıta dayalı en uygun girişimi planlama, uygulama ve değerlendirmede önemli bir yere sahiptir. Hastalarda deliryum gelişimiyle ilişkisi olduğu düşünülen birçok faktörün, çok bileşenli hemşirelik müdahaleleri ile deliryum insidansını ve deliryuma bağlı olumsuz sonuçları azaltılabileceği gösterilmiştir. Bu derlemede deliryumun önlenmesi ve yönetiminde kullanılan çok bileşenli farmakolojik olmayan müdahalelerin literatürde yer alan güncel bilgiler doğrultusunda tartışılması amaçlanmıştır.

Keywords

• Çok bileşenli farmakolojik olmayan yöntemler
• deliryum
• hemşirelik

Multicomponent Non-Pharmacological Nursing Interventions for Prevention of Delirium

Abstract

Delirium is an acute -onset disorder with fluctuating course of attention and changes in thought and/or behavior throughout the day. Although it is associated with the underlying medical condition, it is frequently seen in patients hospitalized in intensive care units. Development of delirium in the patient in the intensive care unit; it negatively affects the length of hospital stay, treatment costs, decreases the cognitive and functional functionality of the patient and increases the incidence of mortality. Nurses, who make a multidimensional evaluation of the patient admitted to the intensive care units for care and treatment, have an important place in planning, applying and evaluating the most appropriate evidence-based intervention in the improvement of risk factors that have an effect on the development of delirium. It shows that many factors that are thought to be related to the development of delirium in patients can be reduced with multi-component nursing interventions, and the incidence of delirium and negative outcomes related to delirium can be reduced. In this review, it is aimed to discuss multi-component non-pharmacological interventions used in the prevention and management of delirium in line with the current information in the literature.

Keywords

• delirium
• multi-component non-pharmacologic strategy
• nursing

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