Sepsis and Nursing Management in the Intensive Care Unit

Yıl 2022, Cilt: 7 Sayı: 2, 415 - 422, 31.05.2022

Zekai Alyat Şerife Baykal Burcu Ünver Seda Kılınç Ayşegül Öztürk Birge

Öz

Sepsis is an important problem that is frequently seen in the intensive care units throughout the world and in Turkey, increasing the risk of morbidity and mortality, the length of stay in the unit and the cost of care. Although the incidence of sepsis is high in critically ill patients, the survival rate increases when diagnosed early. However, when the early warning signs of sepsis are missed, the severity of sepsis increases and organ failure occurs due to septic shock in the patient. Therefore, the Sepsis Survival Campaign Guide draws attention to the first hour after sepsis is diagnosed and recommends that treatment be initiated rapidly during this period. Nurses, who have the opportunity to directly observe the acute changes associated with sepsis in patients in the intensive care units, have an important place in the early diagnosis of sepsis. As the awareness of the multidisciplinary intensive care team and especially of the nurses about sepsis increases, the effectiveness of early diagnosis and treatment will also increase. The aim of this review, which was prepared in line with current literature-based data, is to increase the knowledge and skills of critical care nurses for the diagnosis and treatment of sepsis. For this purpose, the epidemiology, etiology, physiopathology, clinical findings, diagnosis and treatment approaches, and nursing management algorithm in sepsis are discussed in the light of current guidelines in this review. It is thought that this review will guide nurses in the diagnosis and treatment process of sepsis and support care protocols.

Anahtar Kelimeler

Nursing, sepsis, critical care nursing, intensive care unit

Yoğun Bakım Ünitesinde Sepsis ve Hemşirelik Yönetimi

Öz

Sepsis, dünyada ve ülkemizde yoğun bakım ünitelerinde sık görülen, morbidite ve mortalite riskini, hastanın ünitede kalma süresini ve bakım maliyetini arttıran önemli bir sorundur. Kritik hastalarda sepsis görülme insidansı yüksek olmakla birlikte erken tanılandığında sağkalım oranı artmaktadır. Ancak sepsisin erken uyarı bulguları gözden kaçırıldığında hastada sepsis şiddeti artmakta ve septik şok tablosuna bağlı organ yetmezliği gelişmektedir. Bu nedenle Sepsis Sağkalım Kampanya Kılavuzu sepsis tanılandıktan sonraki ilk bir saate dikkati çekmekte ve bu sürede tedavinin hızla başlatılmasını önermektedir. Yoğun bakım ünitelerinde hastada gelişen sepsisle ilişkili akut değişimleri doğrudan gözleme olanağı yüksek olan hemşirelerin sepsisi erken tanılamadaki yeri önemlidir. Multidisipliner yoğun bakım ekibinin ve özellikle de hemşirelerin sepsise ilişkin farkındalıkları arttıkça erken tanılama ve tedavinin etkinliği de artacaktır. Literatüre dayalı güncel veriler doğrultusunda hazırlanan bu derlemenin amacı, yoğun bakım hemşirelerinin sepsis tanı ve tedavisine yönelik bilgi ve becerilerinin arttırılmasıdır. Bu amaçla bu derlemede, güncel kılavuzlar eşliğinde sepsiste epidemiyoloji, etiyoloji, fizyopatoloji, klinik bulgular, tanı ve tedavi yaklaşımları ve hemşirelik yönetim algoritması ele alınmıştır. Derlemenin hemşirelere sepsis tanılama ve tedavi sürecinde yol göstereceği ve bakım protokollerini destekleyeceği düşünülmektedir.

Anahtar Kelimeler

sepsis, Hemşirelik, sepsis, yoğun bakım hemşireliği, yoğun bakım ünitesi

Kaynakça

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