Jinekolojik cerrahide ameliyat öncesi ve sonrası kanıta dayalı bakım uygulamaları

Yıl 2019, Cilt: 6 Sayı: 2, 114 - 121, 30.06.2019

Dilek Bilgiç Hande Yağcan Buse Güler Nuran Nur Aypar

Öz

Giriş ve amaç: Ameliyat öncesi ve sonrası kanıta dayalı uygulamalar, organları koruyarak strese verilen tepkiyi azaltıp iyileşme sürecini hızlandırmakta ve erken taburculuğu sağlamaktadır. Bu nedenle çalışmamızın amacı hemşirelere jinekolojik cerrahide kanıta dayalı uygulamalar hakkında bilgi vermek, hemşirelik literatürüne katkıda bulunmak ve güncel kanıtları hasta bakımında kullanmalarını teşvik etmektir.

Gereç ve yöntem: Derlemede ameliyat öncesi bakımda kanıta dayalı uygulamalar kapsamında hasta danışmanlığı ve eğitimi, ameliyat öncesi optimizasyon, tromboemboli profilaksisi, barsak hazırlığı, beslenme, premedikasyon, antimikrobiyal profilaksi ve cilt hazırlığı; ameliyat sonrası kanıta dayalı uygulamalar kapsamında ameliyat sonrası yaşam bulguları takibi, tromboemboli profilaksisi, spirometre kullanımı, sıvı tedavisi, beslenme, ileusun önlenmesi, glikoz kontrolü, analjezi, üriner drenaj, erken mobilizasyon ve antibiyotik profilaksisi başlıkları tartışılmıştır.

Sonuç: Kanıta dayalı uygulamalara ilişkin literatür incelendiğinde, kolerektal cerrahi geçiren hastalarda yapılan çalışmaların fazla olduğu ancak jinekolojik cerrahi geçiren hastaları içeren çalışmaların sınırlı olduğu görülmektedir. Ayrıca ülkemizdeki hemşirelik çalışmalarına bakıldığında uygulamada kanıtların kullanılmadığı ve hemşirelerin bu sürecin ve ekibin dışında kaldığı göze çarpmaktadır. Hemşireler, ameliyat öncesi ve sonrası dönemde hasta bakımını geleneksel uygulamalar yerine maliyeti, hastanede kalış süresini, komplikasyon ve morbidite oranlarını azaltan, güvenli, etkili ve hasta memnuniyetini arttıran kaliteli bir bakıma dayandırmalıdır.

Anahtar Kelimeler

jinekoloji, kanıta dayalı uygulamalar, hemşirelik

Preoperative and postoperative evidence based practices in gynecologic surgery

Öz

Introduction and objective: Pre-operative and post-operative evidence-based applications protect the organs, reduce the response to stress, speed up the healing process and provide early discharge. Therefore, the aim of our study is to provide nurses information about evidence-based practices in gynecologic surgery, contribute to nursing literature and encourage them to use current evidence in patient care.

Material and method: In the review within the scope of pre-operative care evidence-based practices, it was discussed that patient counseling and training, preoperative optimization, thromboembolism prophylaxis, bowel preparation, nutrition, premedication, antimicrobial prophylaxis and skin preparation. And it was examined that follow-up of post-operative life findings as part of post-operative evidence-based practices, thromboembolism prophylaxis, use of spirometry, fluid therapy, nutrition, prevention of ileus, glucose control, analgesia, urinary drainage, early mobilization and antibiotic prophylaxis.

Conclucion: When the literature on evidence-based applications was examined, it is seen that studies conducted in patients undergoing surgery have been more common but studies involving patients undergoing gynecologic surgery were limited. In addition, when the nursing studies in our country were examined, it was observed that the evidence is not used in practice and the nurses remain outside this process and the team. Nurses should base patient care before and after surgery that safe, effective and high-quality care that increases patient satisfaction and reduces cost, hospital stay, complication and morbidity rates, instead of traditional practices.

Anahtar Kelimeler

Nursing, evidence based practice, gynecology

Kaynakça

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