Zgodnje prepoznavanje sepse pri kritično bolnem bolniku: vidik zdravstvene nege : diplomsko delo

Bombač, Gašper (avtor), Djekić, Bernarda (mentor)

Sepsa je eden izmed glavnih razlogov smrti v enotah intenzivne terapije. Stanje sepse je mnogokrat spregledano, medtem ko se prognoza bolnika ob neodkriti sepsi hitro slabša. Z uporabo presejalnih testov je potrebno zgodaj prepoznati znake in simptome razvijajoče se sepse pri kritično ogroženem bolniku. Namen: Namen diplomskega dela je ugotoviti pojavnost sepse pri kritično ogroženem bolniku v enotah intenzivne terapije, raziskati presejalne teste za zgodnje prepoznavanje sepse ter opredeliti vlogo medicinske sestre pri obravnavi bolnika s sepso. Metode dela: Uporabljena je bila deskriptivna metoda dela s sistematičnim pregledom domače in tuje literature preko spletnega portala digitalne knjižnice Univerze v Ljubljani (DiKUL) v mednarodnih spletnih bazah CINAHL, Medline ter COBIB.SI. Iskanje literature je potekalo s pomočjo ključnih besed/besednih zvez: sepsis OR SIRS, incidence and incidence of sepsis, signs AND simptoms, nursing, screening tools, protocols OR guidelines, management AND treatment, early recognition OR detection of sepsis. V kvalitativno analizo je bilo vključenih 15 raziskav. Rezultati: Pojavnost sepse pri kritično ogroženem bolniku v enotah intenzivne terapije je sorazmeroma visoka in se giblje od 3,6 do 37,4 %. Visoko pojavnost sepse je opaziti tudi na urgentnih oddelkih ter pri bolnikih obravnavanih s strani nujne medicinske pomoči. Na različnih področjih se uporabljajo različni presejalni testi. Trenutno sta v veljavi Hitri presejalni test za ocenjevanje disfunkcije organov povzročene zaradi sepse ter Presejalni test za ocenjevanje disfunkcije organov povzročene zaradi sepse, ki sta potrjena s strani Evropskega združenja za obravnavo sepse. Razprava in sklep: V pregledani literaturi je najti neenotno uporabo izrazov, kot so: sepsa, huda sepsa in septični šok. Še zmeraj sta v uporabi zraza septikemija in septični sindrom. Podatki o pojavnosti nihajo zaradi neenotno uporabljenih definicij sepse, prav tako se pri različnih presejalnih testih za prepoznavo sepse uporablja različne načine diagnosticiranja sepse. Medicinska sestra ima pomembno vlogo pri zgodnjem prepoznavanju znakov in simptomov sepse, prav tako tudi pri obravnavi bolnika s sepso. V slovenskem prostoru je potrebno posodobiti tako definicije sepse, kot tudi protokol za obravnavo bolnika s sepso, ter izvesti raziskavo o pojavnosti sepse v enotah intenzivne terapije. Prav tako je pomembno tudi nadaljnje strokovno izpopolnjevanje in izobraževanje zdravstvenih delavcev na področju sepse in oskrbe bolnika s sepso, s čimer se bo preživetje bolnikov s sepso zaradi zgodnje prepoznave in boljše oskrbe izboljšalo.

• Jezik: Slovenski jezik
• Ključne besede: diplomska dela, zdravstvena nega, sepsa, pojavnost, presejalni testi
• Vrsta gradiva: Diplomsko delo/naloga
• Organizacija: ZF - Zdravstvena fakulteta
• Kraj izida: Ljubljana
• Založnik: [G. Bombač]
• Leto izida: 2017
• Št. strani: 33 str.
• PID: 20.500.12556/RUL-88914
• COBISS.SI-ID: 5230699
• Datum objave v RUL: 31.01.2017

Sekundarni jezik

• Jezik: Angleški jezik
• Naslov: Early recognition of sepsis in critically ill patients: nursing perspective : diploma work

Izvleček

Introduction: Sepsis is one of the most common reasons of patient’s death during the intensive care unit stay. It is often an overlooked condition while the prognosis of the patient worsens every hour. Using the different screening tools it is widely appropriate to recognize sign and symptoms of sepsis as early as possible. Purpose: The purpose of this thesis is to find out the incidence of sepsis in intensive care units, to explore different screening tools which can be used for early recognition of sepsis and to define the role of the nurses while taking care of septic patient. Methods: A descriptive method was carried out using Slovenian and foreign literature throughtout the digital library data from Ljubljana University library (DiKUL), worldwide online basis CINAHL, Medline and COBIB.SI. The following words for literature searching were used: sepsis OR SIRS, incidence and incidence of sepsis, signs AND simptoms, nursing, screening tools, protocols OR guidelines, management AND treatment, early recognition OR detection of sepsis. At the end, 15 different studies were used for analysis. Results: The incidence of sepsis in critically ill patients in intensive care units is pretty high and ranges from 3,6 to 37,4 %. High incidence of sepsis is also found to be a major problem in pre-hospital environment and at the emergency departments. Different hospitals use different screening tools. Surviving Sepsis Campaign, recommends the use of Quick Sepsis−Related Organ Failure Assessment and Sepsis−Related Organ Failure Assessment. Discussion and conclusion: It can be noticed that discordant use of words like sepsis, severe sepsis and septic shock, is still being present in the literature. There are also phrases like septicaemia and sepsis syndrome that are still used in literature but are not suitable anymore. The incidence of sepsis differs because there are different system and definitions being used for defining septic patients. Nurses play an important role for recognizing onset of early sign and symptoms of sepsis and have crucial part while taking care of a septic patient. There is a need to rewrite new definitions for sepsis and septic shock in Slovenian medicine and nursing literature. Protocols for taking care of septic patients must also be updated as soon as possible. It would be useful to investigate the incidence of sepsis in Slovenian intensive care units. It is very important for nurses to be properly educated about it and how to take care of a septic patient. Better knowledge of sepsis among nurses will benefit in the better outcome of a septic patient.

• Ključne besede: diploma theses, nursing care, sepsis, incidence, screening tools