190 research outputs found
Czy w chirurgii czaszki konieczne jest zgolenie włosów?
Shaving the hair before cranial surgery is a common application with the purpose of preventing surgical site infections. However, shaving the hair particularly in women and young patients causes the impairment of the body image and negatively affects the rehabilitation process. In the studies evaluating the wound infections in patients that shaved or unshaved before craniotomy, it has been shown that the infection rate in shaved patients was 1.22 – 8% and 0 – 13.6% in unshaved patients. It was stated in the studies that scalp shaving was not effective in the prevention of surgical site infections, and cranial surgeries can be made safely without shaving scalp with the provision that proper skin preparation is made. In this review, whether or not the scalp shaving is effective in the prevention of surgical site infections and the proper hair and skin preparation before the surgical intervention will be discussed. (PNN 2013;2(2):83-89)W chirurgii czaszki, w celu zapobieżenia zakażeniu miejsca operacyjnego (ZMO) przed przystąpieniem do kraniotomii, często stosowanym zabiegiem jest częściowe lub całkowite zgolenie włosów na głowie. Jednakże szczególnie w przypadku kobiet i pacjentów młodych zgolenie włosów powoduje niekorzystne zmiany wyglądu zewnętrznego i ma negatywny wpływ na proces rehabilitacji. Wyniki badań przypadków zakażenia ran operacyjnych u chorych, u których przed zabiegiem kraniotomii zgolono włosy oraz u tych, których włosów nie zgolono wskazują, że stopień występowania zakażeń w przypadku zgolenia włosów wynosił 1,22% - 8%, a w przypadku niezgolenia włosów 0 – 13,6%. W wyniku przeprowadzonych badań stwierdzono, że zgolenie włosów nie ma wpływu na zapobieżenie ZMO, a w przypadku poprawnego przygotowania skóry zabieg kraniotomii może być bezpiecznie wykonany bez zgolenia włosów. W niniejszym opracowaniu przedyskutowany zostanie temat golenia włosów przed zabiegiem chirurgicznym oraz wpływ lub brak wpływu tej czynności na zapobieganie ZMO, a także jak należy przygotować przed zabiegiem włosy i skórę u pacjentów, u których włosów nie zgolono. (PNN 2013;2(2):83-89
Opieka pielęgniarska nad chorymi z dolegliwościami neurochirurgicznymi w przypadkach nierównowagi sodu
Hormones released from pituitary, hypothalamus and endocrine system are affected in various neurological conditions including traumatic brain injuries, cranial surgeries, and brain tumors can impair the fluid and electrolyte balance of the body. The most frequent sodium imbalance types are the syndromes of inappropriate antidiuretic hormone secretion (SIADH) causing hyponatremia and diabetes insipidus (DI) causing hypernatremia. Hyponatremia related to SIADH and hypernatremia related to DI can cause deterioration of the general medical statuses of the patients and even death through the cerebral edema or cerebral infarcts or low blood pressure related to systemic volume loss and therefore reduce cerebral perfusion pressure, respectively. In this review, the nursing interventions are summarized that could guide the nurses for the early diagnosis and follow-up of the sodium imbalances which are frequently seen in patients staying in neurosurgery clinics. (PNN 2013;2(1):37-42)W wielu stanach neurologicznych, takich jak urazowe uszkodzenie mózgu, zabiegi z zakresu chirurgii czaszki czy guzy nowotworowe mózgu, pod wpływem hormonów wydzielanych przez przysadkę mózgową, podwzgórze oraz systemy układu hormonalnego może zostać zachwiana równowaga płynów ustrojowych oraz równowaga elektrolityczna. Najczęściej spotykane przypadki nierównowagi sodu, to powodujący hiponatremię zespół niewłaściwego uwalniania hormonu antydiuretycznego (SIADH) oraz będący przyczyną hipernatremii diabetes insipitus (DI). Rozwijająca sie z powodu SIADH hiponatremia może doprowadzić do obrzęku lub niedokrwienia mózgu; zaś spowodowana DI hipernatremia doprowadzić może do utraty objętości płynów ustrojowych a w rezultacie do spadku ciśnienia krwi, związanego z tym spadku ciśnienia perfuzyjnego mózgu, a co za tym idzie do pogorszenia stanu klinicznego pacjenta, a nawet do utraty życia. W niniejszym opracowaniu streszczony zostanie opis wczesnego rozpoznawania nierównowagi sodu często występujący u pacjentów leczonych szpitalnie w klinikach neurochirurgicznych oraz opis czynności pielęgniarskich pomocnych pielęgniarkom pracującym w tej dziedzinie. (PNN 2013;2(1):37-42
Determining ethical sensitivity of nurses employed in surgical units
Amaç: Cerrahi birimlerde çalışan hemşirelerin etik ikilemlere karşı duyarlılık düzeylerinin
belirlenmesidir.
Yöntem: Tanımlayıcı türde yapılan bu araştırma, 22 Aralık 2013-15 Ocak 2014 tarihleri arasında
çalışmaya katılmayı kabul eden 90 hemşire ile yürütüldü. Veriler, bireysel özellikler formu ile Ahlaki Duyarlılık
Anketi kullanılarak toplandı. Verilerin analizinde tanımlayıcı istatistikler ile Mann Whitney U ve Kruskal-Wallis
testi kullanıldı.
Bulgular: Cerrahi hemşirelerinin Ahlaki Duyarlılık Anketi toplam puan ortalamasının 89.77±19.43
olduğu; otonomi alt boyut puan ortalamasının 18.35±5.51, çatışma alt boyut puan ortalamasının 13.96±2.97,
yarar sağlama alt boyut puan ortalamasının 12.92±3.95, uygulama alt boyut puan ortalamasının 12.34±3.94,
bütüncül yaklaşım alt boyut puan ortalamasının 12.00±4.88 ve oryantasyon alt boyut puan ortalamasının
8.13±3.88 olduğu saptandı. Hemşirelerin çalışma süreleri ile bütüncül yaklaşım ve oryantasyon alt boyut puan
ortalamaları arasındaki farkın anlamlı olduğu saptandı (p<0.05). Mesleki derneklere üye olma durumu ile
Ahlaki Duyarlılık Anketi toplam ve alt boyut puan ortalamaları karşılaştırıldığında; otonomi, bütüncül yaklaşım
ve oryantasyon alt boyut puan ortalamaları arasındaki farkın anlamlı olduğu bulundu (p<0.05).
Sonuç: Cerrahi birimlerinde çalışan hemşirelerin orta düzey etik duyarlılığa sahip olduğu saptandı.
Hemşirelerin etik sorunları tanıma ve çözüm sağlamada mezuniyet öncesi eğitim programlarının
güçlendirilmesi, mezuniyet sonrası sürekli eğitim programlarının ise hemşirelerin yaş grupları ve deneyim süresi
göz önüne alınarak planlanması, önerilebilir.Aim: It is the determination of sensitivity levels of the nurses employed in surgical units to ethical
dilemmas.
Method: This descriptive study was conducted with 90 nurses who acknowledged to participate in the
study between December 22 2013 and January 15 2014. Data was gathered using the Individual
Characteristics form and the Moral Sensitivity Survey form. Descriptive statistics, Mann Whitney U and
Kruskal-Wallis tests were used in the data analysis.
Results: It was found that total mean score of Moral Sensitivity Survey of the surgical nurses was
89.77±19.43; the subscale mean score of autonomy was 18.35±5.51, subscale mean score of conflict was
13.96±2.97, subscale mean score of benefitting was 12.92±3.95, subscale mean score of implementation was
12.34±3.94, subscale mean score of holistic approach was 12.00±4.88 subscale mean score of orientation was
8.13±3.88. It was found that there was a statistically significant difference between the employment period of the
nurses and the subscale mean scores of holistic approach and orientation (p<0.05). When compared the status
of being member of professional associations with the total score of the Moral Sensitivity Survey and subscale
mean scores, the difference between the subscale mean scores of autonomy, holistic approach and orientation
was significant in statistical manner (p<0.05).
Conclusion: It was found that the nurses employed in the surgical units have a moderate ethical
sensitivity. It can be suggested to strengthen the pre-graduation education programs and to plan the postgraduation continuous education programs by taking into account the age groups and years of experience of
nurses in recognizing the ethical problems and in providing solution
Klinisyen Hemşirelerin Gerçekleştirdikleri Hizmet içi Eğitim (HİE) Programlarının Etkinliğini Arttıracak Öğretim Stratejileri
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