Nursing Approach to Pediatric Intensive Care Patients in Delirium

Yıl 2020, Cilt: 8 Sayı: 3, 964 - 972, 30.11.2020

Abdullah Sarman , Emine Sarman

https://doi.org/10.33715/inonusaglik.726409

Cited By: 1

Öz

Delirium is defined as non-specific organic brain syndrome in which disturbances of consciousness is accompanied by attention, perception, thought, memory, psychomotor-activation, mood, and sleep-wake cycle disturbances. Pediatric delirium is a common condition that causes various neurological and cognitive problems. Pediatric delirium has a prevalence rate of 25% in pediatric intensive care units (PICUs). Patients with delirium who require critical care may more frequently experience longer hospital stay, long-term mechanical ventilation, and post-traumatic stress disorder symptoms. Routine screening for delirium provides early recognition. Pediatric delirium screenings are often not regularly performed in the PICU. There are some obstacles for the application of delirium screenings. One of these is the lack of information among nurses who provide critical care. Nurses have a key role in defining and identifying delirium risks, and providing care by using a valid and reliable tool in pediatric intensive care units. Increasing delirium knowledge of pediatric intensive care nurses, developing an appropriate attitude towards delirium is the first step in alleviating the negative consequences of delirium for children with critical illness. Multi-faceted training increases delirium knowledge, self-esteem and attitude towards delirium for pediatric intensive care nurses. Employees must constantly follow up to recognize delirium. The sustainability of delirium screening and inclusion of application changes require continuous measurement of delirium results and multidisciplinary team communication. In order to better understand the importance of this issue, longitudinal studies are needed in pediatric intensive care units. 

Anahtar Kelimeler

Pediatric intensive care, delirium, nursing, care, child

DELİRYUMDAKİ PEDİATRİK YOĞUN BAKIM HASTALARINA HEMŞİRELİK YAKLAŞIMI

Öz

Deliryum; bilinç değişikliğine dikkat, algı, düşünce, bellek, devinim, duygu-durum ve uyku-uyanıklık döngüsü bozukluklarının eşlik ettiği, özgül olmayan organik beyin sendromu olarak tanımlanır. Pediatrik deliryum, yaygın olarak görülen, çeşitli nörolojik ve bilişsel problemlere neden olan durumdur. Pediatrik deliryum, pediatrik yoğun bakım ünitelerinde (PYBÜ) %25 prevalans oranına sahiptir. Kritik bakıma gereksinim duyan deliryumdaki hastalar daha uzun hastanede kalma, uzun süreli mekanik ventilasyon ve hastane sonrası dönemde travma sonrası stres bozukluğu belirtilerini daha sık yaşayabilmektedirler. Deliryum için rutin yapılan taramalar erken dönemde tanınmasını sağlar. Pediatrik deliryum taramaları çoğu zaman PYBÜ'de düzenli bir şekilde yapılmamaktadır. Deliryum taramalarının uygulanmasının önünde bazı engeller bulunmaktadır. Bunlardan biri kritik bakımı sağlayan hemşireler arasındaki bilgi eksikliğidir. Hemşireler, pediatrik yoğun bakım ünitelerinde geçerli ve güvenilir bir araç kullanarak deliryum risklerinin tanımlanması ve belirlenmesi, ve bakım sağlanmasında kilit role sahiptir. Pediatrik yoğun bakım hemşirelerinin deliryum bilgisini arttırması, deliryuma karşı uygun bir tutum geliştirmesi, kritik hastalığı olan çocuklar için deliryumun olumsuz sonuçlarını hafifletmenin ilk adımıdır. Çok yönlü eğitim, pediatrik yoğun bakım hemşireleri için deliryum bilgisini, özgüveni ve deliryuma karşı olumlu tutumu arttırmaktadır. Çalışanların deliryumu tanıması için sürekli izlem yapması gereklidir. Deliryum taramasının sürdürülebilirliği ve uygulama değişikliklerinin dâhil edilmesi, deliryum sonuçlarının sürekli olarak ölçülmesini ve multidisipliner ekip iletişimini gerektirir. Bu konunun önemini daha iyi anlamak için pediatrik yoğun bakım ünitelerinde boylamsal çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

Pediyatrik yoğun bakım, deliryum, hemşirelik, bakım, çocuk

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