Vloga medicinske sestre pri mehanski tromboprofilaksi globoke venske tromboze pri kritično bolnih : diplomsko delo

Trobec, Simona (avtor), Djekić, Bernarda (mentor), Vahčič, Mija (komentor), Bizjak, Martina (recenzent)

Uvod: Globoka venska tromboza je pogost zaplet pri zdravljenju kritično bolnih v enotah intenzivnega zdravljenja. Gre za življenje ogrožajoče stanje, ki ga je mogoče do določene mere preprečiti, vendar je za to potrebna primerna tromboprofilaksa, ki je lahko kemična ali mehanska. Namen: Namen diplomskega dela je na podlagi pregleda literature predstaviti učinkovitost in uporabo naprav za intermitentno pnevmatsko kompresijo, izkušnje medicinskih sester ter ugotoviti dejavnike, ki vplivajo na varnost pri njihovi uporabi. Metode dela: Uporabljena je bila deskriptivna metoda dela s pregledom slovenske in angleške strokovne in znanstvene literature v mednarodnih spletnih podatkovnih bazah CINAHL in Medline. Slovenska literatura je bila iskana preko vzajemne kataloške baze podatkov COBISS.SI in fizično v knjižnici Zdravstvene fakultete Univerze v Ljubljani. Za vsebinsko analizo je bilo uporabljenih 12 enot literature, ki je bila vrednotena s 4-stopenjsko lestvico. Rezultati: Naprave za intermitentno pnevmatsko kompresijo so učinkovita in varna mehanska tromboprofilaksa. Po podatkih raziskav njihova uporaba pomembno zmanjša tveganje za nastanek globoke venske tromboze. Medicinske sestre imajo pomembno vlogo pri pravilni uporabi aparatur za mehansko tromboprofilakso. Njihova nepravilna uporaba je lahko razlog za neučinkovitost mehanske tromboprofilakse. V raziskavah sta izpostavljeni dve pogosti napaki: manšete niso nameščene, čeprav jih kritično bolni potrebuje in naprave niso vklopljene. Medicinske sestre so navajale težave z namestitvijo manšet in neprimerno izbrano oz. uporabljeno velikostjo manšete. Težave zaradi uporabe naprav za intermitentno pnevmatsko kompresijo so imeli tudi bolniki, saj so tožili o potenju, nenehnem stiskanju in motnjah spanja. Prepoznane so bile tudi poškodbe kože in padci zaradi omejene gibljivosti ob uporabi manšet. Razprava in zaključek: Pomembna je pravočasna in sistematična ocena tveganja za pojav globoke venske tromboze ter individualno oblikovan načrt tromboprofilakse. Naprave za intermitentno pnevmatsko kompresijo so primerna izbira za preventivo globoke venske tromboze pri kritično bolnih. Za njihovo pravilno uporabo je pomembno znanje, zato potrebujejo zdravstveni delavci kontinuirano strokovno usposabljanje. Pozorni morajo biti na ovire, ki vplivajo na neučinkovito mehansko tromboprofilakso. Tema je v slovenskem prostoru slabo raziskana, zato je diplomsko delo lahko izhodišče za nadaljnje raziskave.

• Jezik: Slovenski jezik
• Ključne besede: diplomska dela, zdravstvena nega, intermitentne pnevmatske kompresijske naprave, nepravilna uporaba, izkušnje medicinskih sester, zapleti, varnost
• Vrsta gradiva: Diplomsko delo/naloga
• Tipologija: 2.11 - Diplomsko delo
• Organizacija: ZF - Zdravstvena fakulteta
• Kraj izida: Ljubljana
• Založnik: [S. Trobec]
• Leto izida: 2020
• Št. strani: 24 str.
• PID: 20.500.12556/RUL-121186
• UDK: 616-083
• COBISS.SI-ID: 30742531
• Datum objave v RUL: 01.10.2020

TROBEC, Simona, 2020, Vloga medicinske sestre pri mehanski tromboprofilaksi globoke venske tromboze pri kritično bolnih : diplomsko delo [na spletu]. Diplomsko delo. Ljubljana : S. Trobec. [Dostopano 21 april 2025]. Pridobljeno s: https://repozitorij.uni-lj.si/IzpisGradiva.php?lang=slv&id=121186

Sekundarni jezik

• Jezik: Angleški jezik
• Naslov: The role of the nurse in mechanical thromboprophylaxis of deep vein thrombosis of critically ill patient : diploma work

Izvleček

Introduction: Deep vein thrombosis is a common complication in treatment of critically ill patients in intensive care units. It is a life-threatening condition, which can be prevented to a certain amount with a suitable chemical or mechanical thromboprophylaxis. Purpose: The purpose of the thesis is to perform a literature review to present the efficiency and usage of devices for intermittent pneumatic compression, describe nurses’ experiences with them, as well as identify factors, which influence safety during their usage. Methods: A descriptive method with a review of Slovene and English professional and scientific literature was used. The search was made using the Digital Library of the University of Ljubljana (DiKUL) portal and international online databases CINAHL and Medline. Slovene literature was searched in the COBISS.SI mutual catalogue database and in the library of the Faculty of Health Sciences of the University of Ljubljana. For content analysis we used 12 units of literature, which were assessed by a 4-stage scale. Results: Devices for intermittent pneumatic compression are an efficient and safe mechanical thromboprophylaxis. According to findings of studies use of these devices significantly decreases the risk for development of deep vein thrombosis. Nurses have an important role in correct use of devices for mechanical thromboprophylaxis. The incorrect use of these devices can be the reason for inefficient mechanical thromboprophylaxis. In the examined articles are pointed out two common mistakes: cuffs are not placed, even though critically ill patients need them, and devices are not turned on. Nurses had problems with placing the cuffs and unsuitable cuff size. Patients also had issues with devices for intermittent pneumatic compression. They reported troubles, such as sweating, constant compressing and sleep disturbance. Injuries of skin and falls due to limited movement while using these devices were also mentioned. Discussion and conclusion: It is important to perform a timely and systematic risk assessment for deep vein thrombosis and make an individual plan of thromboprophylaxis. Devices for intermittent pneumatic compression are a suitable choice for prevention of deep vein thrombosis in critically ill patients. For a correct use of these devices is needed knowledge. Therefore, health care workers need continuous professional training. They have to pay attention to the obstacles which affect efficiency of mechanical thromboprophylaxis. This topic is scarcely examined in Slovenia, so the thesis could be used as a source for further research.

• Ključne besede: diploma theses, nursing care, intermittent pneumatic compression devices, incorrect use, nurses’ experiences, complications, safety