Yoğun Bakım Hastalarında Prone Pozisyonu ve Basınç Yaralanmaları: Güncel Yaklaşımlar ve Kanıtlar

Öz

Basınç yaralanmalarının önlenmesinde kanıta dayalı birçok uygulama olmakla birlikte en önemlilerinden biri risk altındaki hastalara kontrendikasyon olmadığı sürece pozisyon vermektir. Bu pozisyonlardan biri prone pozisyonudur ve yoğun bakımdaki hastaların tedavi planında yer alabilmektedir. Prone pozisyonu akciğeri korumak için uygulanan ventilasyon stratejilerinden biridir. Prone pozisyonu; ventilasyon ile ilişkili akciğer hasarını en aza indirmek, akciğer heterojenitesini azaltmak ve gaz değişimi ile solunum mekaniklerini iyileştirmek için kullanılan bir tedavi yöntemidir. Prone pozisyonu oksijenasyonu iyileştirmek için kullanılmakla birlikte basınç yaralanmalarına da neden olabilmektedir. Prone pozisyonunda basınç yaralanmalarının meydana gelmesi, hastaların cildinin ve basınç yaralanması riskinin düzenli olarak değerlendirilmesinin, proaktif bir yaklaşımla birlikte önleyici tedbirlerin uygulanmasının çok önemli olduğunu göstermektedir. Bu derlemede yoğun bakım hastalarında prone pozisyonunun önemi, prone pozisyonuna bağlı basınç yaralanmasının gelişimi, önlenmesi için girişimler ve bu kapsamda hemşirelik yaklaşımının incelenmesi amaçlanmıştır. Anahtar kelimeler: Prone pozisyonu, basınç yaralanmaları, yoğun bakım, hemşirelik.

Anahtar Kelimeler

• Prone poziyonu
• basınç yaralanmaları
• yoğun bakım
• hemşirelik

PRONE POSITION AND PRESSURE INJURIES IN INTENSIVE CARE PATIENTS: CURRENT APPROACHES AND EVIDENCE

Abstract

Although there are many evidence-based practices in the prevention of pressure injuries, one of the most important one is positioning patients at risk unless there is a contraindication. One of these positions is the prone position and can be included in the treatment plan of patients in the intensive care unit. The prone position is one of the ventilation strategies used to protect the lung. The prone position is a treatment method used to minimize ventilation-related lung damage, reduce lung heterogeneity, and improve respiratory mechanics with gas exchange. Although the prone position is used to improve oxygenation, it can also cause pressure injuries. The occurrence of pressure injuries in the prone position shows that it is very important to evaluate patients' skin regularly and the risk of pressure injuries and to implement preventive measures with a proactive approach. This review aims to examine the importance of prone position in intensive care patients, the development of pressure injuries due to prone position, interventions for prevention, and the nursing approach in this context. Keywords: Prone position, pressure ulcer, intensive care, nursing.

Keywords

• Prone position
• pressure ulcer
• intensive care
• nursing

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