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Hemşireler Trakeostomili Hastaların Bakımını Ne Kadar Biliyor? Nitel Bir Çalışma

Yıl 2021, , 72 - 78, 25.06.2021
https://doi.org/10.33716/bmedj.878782

Öz

Amaç: Bu çalışma yoğun bakım hemşirelerinin trakeostomili hasta bakımına ilişkin uygulamalarını belirlemek için yapılmıştır. Gereç ve Yöntemler: Nitel tipteki araştırma Ekim-Kasım 2019 tarihleri arasında Güneydoğu Anadolu Bölgesi’ndeki bir ilde yer alan bir Üniversite Hastanesi’nin Yoğun Bakım Ünitesi’nin 15 hemşiresi ile gerçekleştirilmiştir. Veriler tanıtıcı bilgi formu ve yarı yapılandırılmış görüşme formu kullanılarak toplanmıştır. Veriler, Giorgi’nin fenomenolojik yöntem analizi kullanılarak 4 aşamada değerlendirilmiştir. Bulgular: Katılımcıların yaşları 25-42 aralığında, 10’u kadın, yoğun bakım hemşiresi olarak çalışma yılı 1-15 yıl olup, tüm katılımcıların lisans mezunu olduğu, trakeostomili hastaların bakımı ile ilgili eğitim aldığı ve hasta güvenliği ile ilgili bir yayını/web sayfasını düzenli olarak takip etmediği görülmüştür. Katılımcıların trakeostomili hasta bakımına ilişkin görüşleri 2 ana tema ve 5 alt temadan oluşmaktadır. Ana temalar 1. Trakeostomili Hastanın Bakım Uygulamaları ve 2. Bakım Sırasında Yaşanan Sorunlar ve Çözüm Önerileri’dir. Trakeostomili Hastanın Bakım Uygulamaları ana teması Protokoller, Trakeostomi Öncesi Hasta Bakımı ve Trakeostomi Sonrası Hasta Bakımı olmak üzere 3 alt temadan oluşmaktadır. Bakım Sırasında Yaşanan Sorunlar ve Çözüm Önerileri ana teması Sorun Yaratan Durumlar ve Bakımı Geliştirmeye Yönelik Öneriler olmak üzere 2 alt temadan oluşmaktadır. Sonuç: Hemşirelerin trakeostomili hastanın bakımına ilişkin bilgilerinin temel düzeyde yeterli olup bakım uygulamalarının fizyolojik gereksinimler ile sınırlı kaldığı;hemşirelerin hastanın psikolojik gereksinimlerinin farkında oldukları ancak bu konu ileilgili hemşirelik uygulamalarının ya hiç yapılmadığı ya da yetersiz kaldığı belirlenmiştir.

Kaynakça

  • Frost EA. Tracing the tracheostomy. Ann Otol Rhinol Laryngol. 1976; 85(1): 618-24. doi: 10.1177/000348947608500509.
  • Eavey R. The history of tracheotomy. İn: Myers E, Johnson J, Murry T, editors. Tracheotomy: Airway Management,Communication, and Swallowing. San Diego: Singular; 1998.
  • Batra TK, Tilak MR, Pai E, Verma N, Gupta BK, Yadav G, et al. Increased tracheostomy rates in head and neck cancer surgery during the COVİD-19 pandemic. International Journal of Oral Maxillofacial Surgery. 2020; S0901-5027(20)30441-0. doi: 10.1016/j.ijom.2020.12.002.
  • Cramer JD, Evan MG, Johnson BM. Mortality associated with tracheostomy complications in the United States: 2007–2016. The Laryngoscope. 2019; 129 (3): 619-26. doi:10.1002/lary.27500.
  • Muller RG, Mamidala MP, Smith SH, Smith A, Sheyn A. Incidence, epidemiology, and outcomes of pediatric tracheostomy in the United States from 2000 to 2012. Otolaryngology–Head and Neck Surgery. 2019; 160(2): 332-8. doi: 10.1177/0194599818803598.
  • Watters K, O’Neill M, Zhu H, Graham RJ, Hall M, Berry J. Two‐year mortality, complications, and healthcare use in children with medicaid following tracheostomy. The Laryngoscope. 2016; 126(11): 2611-2617.
  • Spataro E, Durakovic N, Kallogjeri D, Nussenbaum B. Complications and 30‐day hospital readmission rates of patients undergoing tracheostomy: A prospective analysis. The Laryngoscope. 2017; 127(12): 2746-2753. doi: 10.1002/lary.26668.
  • Altınbaş Y, Karaca T. Peristomal Cilt Problemleri: Sistematik Literatür Inceleme. STED. 2018; 27(2): 107-117.
  • Potter PA, Perry AG, Hall A, Stockert PA. Fundamentals of nursing. 7th ed. USA: Mosby; 2009.
  • McGrath BA, Wallace S, Lynch J, Bonvento B, Coe B, Owen A, Cameron T. Improving tracheostomy care in the United Kingdom: results of a guided quality improvement programme in 20 diverse hospitals. British Journal of Anaesthesia. 2020; doi: 10.1016/j.bja.2020.04.064.
  • Sandler ML, Ayele N, Ncogoza I, Blanchette S, Munhall DS, Marques B, Nuss RC. Improving tracheostomy care in resourcelimited settings. Annals of Otology, Rhinology & Laryngology. 2020; 129(2): 181-190. doi: 10.1177/0003489419882972.
  • Karaca T. Nursing care of the patients with tracheostomy. Journal of Human Sciences. 2015; 12(2): 1078-1091. doi: 10.14687/ijhs.v12i2.3320.
  • Seyman ÇC, Çelik SŞ. Trakeostomili hastalarda yaşam kalitesi ve hemşirelik bakımı. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi. 2019; 6(1): 59-64. doi: 10.31125/hunhemsire.544140.
  • McDonough K, Crimlisk J, Nicholas P, Cabral H, Quinn EK, Jalisi, S. Standardizing nurse training strategies to improve knowledge and self-efficacy with tracheostomy and laryngectomy care. Applied Nursing Research. 2016; 32: 212-216. doi: 10.1016/j.apnr.2016.08.003.
  • El-Gawab, HM. Quality of nursing care on patients with tracheostomy. Port Said Scientific Journal of Nursing. 2017; 4(1): 202-216. doi: 10.21608/PSSJN.2017.33096.
  • Mungan İ, Kazancı D, Bektaş Ş, Sarı S, Çavuş M, Turan S. The evaluation of nurses’ knowledge related to tracheostomy care in tertiary intensive care units. International Medicine. 2019; 1(6): 313-318. doi: 10.5455/im.54258.
  • Ersoy AF. Fenomenoloji. 3. Baskı. Saban A, Ersoy A, editörler, Eğitimde nitel araştırma desenleri; 2019; Ankara. Anı Yayıncılık; 81-138.
  • Leininger M. Qualitative research methods in nursing. USA: Greyden Pres; 1998.
  • Giorgi A, Giorgi B. Phenomenology. In J. A. Smith (Ed.), Qualitative psychology: A practical guide to research methods. London: Sage Publications. 2003; 25-50.20. Heyd CP, Desiato VM, Nguyen SA, O’Rourke AK, Clemmens CS, Awad MI.Tracheostomy protocols during COVİD‐19 pandemic. Head & neck. 2020; 42(6): 1297-1302. doi: 10.1002/hed.26192.
  • Rovira A, Dawson D, Walker A, Tornari C, Dinham A, Foden N, et al. Tracheostomy care and decannulation during the COVİD-19 pandemic. A multidisciplinary clinical practice guideline. European Archives of Oto-Rhino-Laryngology. 2020; 1-9. doi: 10.1007/s00405-020-06126-0.
  • Berman A, Synder S, Kozier B, Erb G. Fundamentals of nursing. 8th ed. USA: Mosby; 2012.
  • Harkreader H, Hogan MA, Thobaben M. Fundamentals of nursing. 3th ed. USA: Mosby; 2007.
  • Seyman ÇC, Çelik SŞ. Effect of protective cover on the quality of life of patients with tracheostomy -A Quasi-Experimental Study. Journal of Peri Anesthesia Nursing. 2020; 35(4): 430-436. doi: 10.1016/j.jopan.2020.01.013.
  • Dawson D. Essential principles: tracheostomy care in the adult patient. British Association of Critical Care Nurses. 2014; 19 (2): 63-72. doi: 10.1111/nicc.12076.
  • Karaca T, Korkmaz FA. Quasi-experimental study to explore the effect of barrier cream on the peristomal skin of patients with a tracheostomy. Ostomy/wound management. 2018; 64(3): 32-39. doi: 10.25270/owm.2018.3.3239.
  • Black MJ, Hawks JH. Medical-surgical nursing. 8th ed. USA: Saunders; 2009.
  • Gomes-Silva BN, Andriolo RB, Saconato H, Atallah AN, Valente O. Early versus late tracheostomy for critically ill patients.Cochrane Database Systematic Review.2012; 14(3): doi: 10.1002/14651858.CD007271.pub3.
  • Herritt B, Chaudhuri D, Thavorn K, Kubelik D, Kyeremanteng K. Early vs. late tracheostomy in intensive care settings: Impact on ICU and hospital costs. Journal of Critical Care. 2018; 44: 285- 288. doi: 10.1016/j.jcrc.2017.11.037.
  • Siempos II, Ntaidou TK, Filippidis FT, Choi AMK. Effect of early versus late or no tracheostomy on mortality and pneumonia of critically ill patients receiving mechanical ventilation: a systematic review and metaanalysis. Lancet Respir Med 2015; 3(2): 150-158. doi: 10.1016/S2213-2600(15)00007-7.
  • Aygencel G, Kemaloğlu YK. COVİD-19 olan yoğun bakım hastalarında trakeostomi uygulamaları. Kulak Burun Boğaz ve Baş Boyun Cerrahisi Dergisi. 2020; 28(Suppl): 84-89. doi: 10.24179/kbbbbc.2020-76492.
  • Garner JM, Moyle MS, Franzese CB. Adult outpatient tracheostomy care: practices and perspectives. Otolaryngology-Head and Neck Surgery. 2007; 136(2), 301-306. doi: 10.1016/j.otohns.2006.08.023.
  • Sherlock ZV, Wilson JA, Exley C. Tracheostomy in the acute setting: patient experience and information needs. Journal of Critical care. 2009; 24(4): 501-507. doi: 10.1016/j.jcrc.2008.10.007.
  • Nakarada-Kordic I, Patterson N, Wrapson J, Reay SD. A systematic review of patient and caregiver experiences with a tracheostomy. The Patient-Patient-Centered Outcomes Research. 2018; 11(2): 175-191. doi: 10.1007/s40271-017-0277-1.
  • Karaca T, Altinbas Y, Aslan S. Tracheostomy care education and its effect on knowledge and burden of caregivers of elderly patients: a quasi‐experimental study. Scandinavian Journal of Caring Sciences. 2019; 33(4): 878-884. doi: 10.1111/scs.12684.
  • Barnett M. Adapting to living with a tracheostomy. Journal of Community Nursing. 2006; 20(1): 4.
  • Laakso K, Markström A, Havstam C, Idvall M, Hartelius L. Communicating with individuals receiving home mechanical ventilation: the experiences of key communication partners. Disability and Rehabilitation. 2014; 36(11): 875-883. doi: 10.3109/09638288.2013.822572.
  • Masood MM, Farquhar DR, Biancaniello C, Hackman TG. Association of standardized tracheostomy care protocol implementation and reinforcement with the prevention of life-threatening respiratory events. JAMA Otolaryngology–Head & Neck Surgery. 2018; 144(6): 527-532. doi: 10.1001/jamaoto.2018.0484.

How Much Do Nurses Know About the Care of Patients with Tracheostomy? A Qualitative Study

Yıl 2021, , 72 - 78, 25.06.2021
https://doi.org/10.33716/bmedj.878782

Öz

Aim: This study was conducted to determine the practices of intensive care nurses regarding patient care with tracheostomy. Material and Method: A qualitative type research was carried out with 15 nurses of the Intensive Care Unit of a University Hospital located in a province in the Southeastern Anatolia Region between October-November 2019. Data were collected using an introductory information form and a semi-structured interview form. The data were evaluated in 4 stages using Giorgi’s phenomenological method analysis. Results: It was observed that the age of the participants is between 25-42, 10 of them are women, the working year as an intensive care nurse is 1-15 years, all the participants were undergraduate, received training on the care of patients with tracheostomy, and did not regularly follow a publication/web page on patient safety. Participants’ views on patient care with tracheostomy consist of 2 main themes and 5 sub themes. Main themes are Care Practices of Patient with Tracheostomy and Problems Encountered During Care and Solution Suggestions. The main theme of Patient Care Practices with Tracheostomy is Protocols, Pre-Tracheostomy Patient Care and Post Tracheostomy Patient Care. Problems Encountered During Care and Solution Suggestions consist of 2 subthemes, the main theme of which is Problematic Situations and Suggestions for Improving Care. Conclusion: It was determined that nurses’ knowledge of the care of patients with tracheostomy is sufficient at a basic level and care practices are limited to physiological needs; nurses were aware of the psychological needs of the patient, but nursing practices related to this issue were either not performed at all or were inadequate.

Kaynakça

  • Frost EA. Tracing the tracheostomy. Ann Otol Rhinol Laryngol. 1976; 85(1): 618-24. doi: 10.1177/000348947608500509.
  • Eavey R. The history of tracheotomy. İn: Myers E, Johnson J, Murry T, editors. Tracheotomy: Airway Management,Communication, and Swallowing. San Diego: Singular; 1998.
  • Batra TK, Tilak MR, Pai E, Verma N, Gupta BK, Yadav G, et al. Increased tracheostomy rates in head and neck cancer surgery during the COVİD-19 pandemic. International Journal of Oral Maxillofacial Surgery. 2020; S0901-5027(20)30441-0. doi: 10.1016/j.ijom.2020.12.002.
  • Cramer JD, Evan MG, Johnson BM. Mortality associated with tracheostomy complications in the United States: 2007–2016. The Laryngoscope. 2019; 129 (3): 619-26. doi:10.1002/lary.27500.
  • Muller RG, Mamidala MP, Smith SH, Smith A, Sheyn A. Incidence, epidemiology, and outcomes of pediatric tracheostomy in the United States from 2000 to 2012. Otolaryngology–Head and Neck Surgery. 2019; 160(2): 332-8. doi: 10.1177/0194599818803598.
  • Watters K, O’Neill M, Zhu H, Graham RJ, Hall M, Berry J. Two‐year mortality, complications, and healthcare use in children with medicaid following tracheostomy. The Laryngoscope. 2016; 126(11): 2611-2617.
  • Spataro E, Durakovic N, Kallogjeri D, Nussenbaum B. Complications and 30‐day hospital readmission rates of patients undergoing tracheostomy: A prospective analysis. The Laryngoscope. 2017; 127(12): 2746-2753. doi: 10.1002/lary.26668.
  • Altınbaş Y, Karaca T. Peristomal Cilt Problemleri: Sistematik Literatür Inceleme. STED. 2018; 27(2): 107-117.
  • Potter PA, Perry AG, Hall A, Stockert PA. Fundamentals of nursing. 7th ed. USA: Mosby; 2009.
  • McGrath BA, Wallace S, Lynch J, Bonvento B, Coe B, Owen A, Cameron T. Improving tracheostomy care in the United Kingdom: results of a guided quality improvement programme in 20 diverse hospitals. British Journal of Anaesthesia. 2020; doi: 10.1016/j.bja.2020.04.064.
  • Sandler ML, Ayele N, Ncogoza I, Blanchette S, Munhall DS, Marques B, Nuss RC. Improving tracheostomy care in resourcelimited settings. Annals of Otology, Rhinology & Laryngology. 2020; 129(2): 181-190. doi: 10.1177/0003489419882972.
  • Karaca T. Nursing care of the patients with tracheostomy. Journal of Human Sciences. 2015; 12(2): 1078-1091. doi: 10.14687/ijhs.v12i2.3320.
  • Seyman ÇC, Çelik SŞ. Trakeostomili hastalarda yaşam kalitesi ve hemşirelik bakımı. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi. 2019; 6(1): 59-64. doi: 10.31125/hunhemsire.544140.
  • McDonough K, Crimlisk J, Nicholas P, Cabral H, Quinn EK, Jalisi, S. Standardizing nurse training strategies to improve knowledge and self-efficacy with tracheostomy and laryngectomy care. Applied Nursing Research. 2016; 32: 212-216. doi: 10.1016/j.apnr.2016.08.003.
  • El-Gawab, HM. Quality of nursing care on patients with tracheostomy. Port Said Scientific Journal of Nursing. 2017; 4(1): 202-216. doi: 10.21608/PSSJN.2017.33096.
  • Mungan İ, Kazancı D, Bektaş Ş, Sarı S, Çavuş M, Turan S. The evaluation of nurses’ knowledge related to tracheostomy care in tertiary intensive care units. International Medicine. 2019; 1(6): 313-318. doi: 10.5455/im.54258.
  • Ersoy AF. Fenomenoloji. 3. Baskı. Saban A, Ersoy A, editörler, Eğitimde nitel araştırma desenleri; 2019; Ankara. Anı Yayıncılık; 81-138.
  • Leininger M. Qualitative research methods in nursing. USA: Greyden Pres; 1998.
  • Giorgi A, Giorgi B. Phenomenology. In J. A. Smith (Ed.), Qualitative psychology: A practical guide to research methods. London: Sage Publications. 2003; 25-50.20. Heyd CP, Desiato VM, Nguyen SA, O’Rourke AK, Clemmens CS, Awad MI.Tracheostomy protocols during COVİD‐19 pandemic. Head & neck. 2020; 42(6): 1297-1302. doi: 10.1002/hed.26192.
  • Rovira A, Dawson D, Walker A, Tornari C, Dinham A, Foden N, et al. Tracheostomy care and decannulation during the COVİD-19 pandemic. A multidisciplinary clinical practice guideline. European Archives of Oto-Rhino-Laryngology. 2020; 1-9. doi: 10.1007/s00405-020-06126-0.
  • Berman A, Synder S, Kozier B, Erb G. Fundamentals of nursing. 8th ed. USA: Mosby; 2012.
  • Harkreader H, Hogan MA, Thobaben M. Fundamentals of nursing. 3th ed. USA: Mosby; 2007.
  • Seyman ÇC, Çelik SŞ. Effect of protective cover on the quality of life of patients with tracheostomy -A Quasi-Experimental Study. Journal of Peri Anesthesia Nursing. 2020; 35(4): 430-436. doi: 10.1016/j.jopan.2020.01.013.
  • Dawson D. Essential principles: tracheostomy care in the adult patient. British Association of Critical Care Nurses. 2014; 19 (2): 63-72. doi: 10.1111/nicc.12076.
  • Karaca T, Korkmaz FA. Quasi-experimental study to explore the effect of barrier cream on the peristomal skin of patients with a tracheostomy. Ostomy/wound management. 2018; 64(3): 32-39. doi: 10.25270/owm.2018.3.3239.
  • Black MJ, Hawks JH. Medical-surgical nursing. 8th ed. USA: Saunders; 2009.
  • Gomes-Silva BN, Andriolo RB, Saconato H, Atallah AN, Valente O. Early versus late tracheostomy for critically ill patients.Cochrane Database Systematic Review.2012; 14(3): doi: 10.1002/14651858.CD007271.pub3.
  • Herritt B, Chaudhuri D, Thavorn K, Kubelik D, Kyeremanteng K. Early vs. late tracheostomy in intensive care settings: Impact on ICU and hospital costs. Journal of Critical Care. 2018; 44: 285- 288. doi: 10.1016/j.jcrc.2017.11.037.
  • Siempos II, Ntaidou TK, Filippidis FT, Choi AMK. Effect of early versus late or no tracheostomy on mortality and pneumonia of critically ill patients receiving mechanical ventilation: a systematic review and metaanalysis. Lancet Respir Med 2015; 3(2): 150-158. doi: 10.1016/S2213-2600(15)00007-7.
  • Aygencel G, Kemaloğlu YK. COVİD-19 olan yoğun bakım hastalarında trakeostomi uygulamaları. Kulak Burun Boğaz ve Baş Boyun Cerrahisi Dergisi. 2020; 28(Suppl): 84-89. doi: 10.24179/kbbbbc.2020-76492.
  • Garner JM, Moyle MS, Franzese CB. Adult outpatient tracheostomy care: practices and perspectives. Otolaryngology-Head and Neck Surgery. 2007; 136(2), 301-306. doi: 10.1016/j.otohns.2006.08.023.
  • Sherlock ZV, Wilson JA, Exley C. Tracheostomy in the acute setting: patient experience and information needs. Journal of Critical care. 2009; 24(4): 501-507. doi: 10.1016/j.jcrc.2008.10.007.
  • Nakarada-Kordic I, Patterson N, Wrapson J, Reay SD. A systematic review of patient and caregiver experiences with a tracheostomy. The Patient-Patient-Centered Outcomes Research. 2018; 11(2): 175-191. doi: 10.1007/s40271-017-0277-1.
  • Karaca T, Altinbas Y, Aslan S. Tracheostomy care education and its effect on knowledge and burden of caregivers of elderly patients: a quasi‐experimental study. Scandinavian Journal of Caring Sciences. 2019; 33(4): 878-884. doi: 10.1111/scs.12684.
  • Barnett M. Adapting to living with a tracheostomy. Journal of Community Nursing. 2006; 20(1): 4.
  • Laakso K, Markström A, Havstam C, Idvall M, Hartelius L. Communicating with individuals receiving home mechanical ventilation: the experiences of key communication partners. Disability and Rehabilitation. 2014; 36(11): 875-883. doi: 10.3109/09638288.2013.822572.
  • Masood MM, Farquhar DR, Biancaniello C, Hackman TG. Association of standardized tracheostomy care protocol implementation and reinforcement with the prevention of life-threatening respiratory events. JAMA Otolaryngology–Head & Neck Surgery. 2018; 144(6): 527-532. doi: 10.1001/jamaoto.2018.0484.
Toplam 37 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm ARAŞTIRMA MAKALESİ
Yazarlar

Yasemin Altınbaş 0000-0002-0456-3236

Türkan Karaca 0000-0002-8603-5460

Yayımlanma Tarihi 25 Haziran 2021
Yayımlandığı Sayı Yıl 2021

Kaynak Göster

APA Altınbaş, Y., & Karaca, T. (2021). Hemşireler Trakeostomili Hastaların Bakımını Ne Kadar Biliyor? Nitel Bir Çalışma. Balıkesir Medical Journal, 5(2), 72-78. https://doi.org/10.33716/bmedj.878782