Gülay Altun UĞRAŞ, Serpil YÜKSEL, Seher Gürdil YILMAZ, Keziban ŞİRİN, Yüksel TURAN, Selin EROĞLU

Nöroşirurji Yoğun Bakım Ünitesinde Ateş Kontrolünde Uygulanan Hemşirelik Girişimleri

Giriş-Amaç: Bedenin önemli savunma mekanizmalarından biri olan ateş, nöroşirürji hastalarında metabolik aktiviteyi hızlandırarak, kafa içi basınç KİB artışına neden olmakta ve iyileşme sürecini olumsuz etkilemektedir. Literatürde, nöroşirürji hastalarında ateş kontrolünün, ateşe bağlı gelişebilecek sorunların önlenmesinde etkili olduğu bildirilmektedir.Gereç-Yöntem: Retrospektif tanımlayıcı tipteki bu araştırma, bir üniversite hastanesinin Nöroşirürji Yoğun Bakım Ünitesi’nde NYBÜ , en az bir hafta yatan ve aksillar beden sıcaklığı > 38°C olan, 18 yaş ve üzeri 72 hasta dosyası incelenerek gerçekleştirildi. Araştırmanın uygulanabilmesi için ilgili kurumdan ve yerel etik kuruldan yazılı izin alındı. Veriler, Eylül 2013-Şubat 2014 tarihleri arasında araştırmacılar tarafından geliştirilen veri toplama formuyla toplandı. Veri analizinde; tanımlayıcı istatistiksel yöntemler frekans, ortalama, standart sapma kullanıldı.Bulgular: NYBÜ’nde 2010- 2014 yılları arasında en az 1 hafta yatan 180 hastadan 72’sinde %40 ateş oluştuğu saptandı. Ateş kontrolünü sağlamak amacıyla hemşireler tarafından uygulanan başlıca girişimlerin, hekim istemi ile antipretik ilaç tedavisi uygulama %98,6 , fan/vantilatör kullanma %88,9 , ılık silme banyo verme %75 ve odanın sıcaklığını ayarlama/battaniyeleri uzaklaştırma %72,2 olduğu belirlendi. En sık kullanılan antipretik ilaçların, metamizol sodyum %27,8 , metamizol sodyumasetaminofen kombinasyonu %26,4 ve asetaminofen %16,7 olduğu saptandı. Sonuç: Araştırmadan elde edilen verilere göre, NYBÜ’nde yatan hastalarda ateş kontrolünü sağlamak amacıyla en yaygın kullanılan yöntemin farmakolojik tedavi olduğu, en sık uygulanan hemşirelik girişimlerinin de, fiziksel soğutmayı sağlayan yöntemler olduğu saptandı

NURSING INTERVENTIONS TO CONTROL FEVER IN A NEUROSURGICAL INTENSIVE CARE UNIT

Introduction: Whilst fever is one of the key defence mechanisms of the body, it also causes raised intracranial pressure ICP by accelerating metabolic activity in neurosurgical patients and adversely affects the healing process. In the literature, fever control in neurosurgical patients is reported to be effective in preventing adverse consequences arising from uncontrolled fever.Material and Methods: This study employs a retrospective descriptive methodology. It was undertaken by examining a sample of medical records for 72 patients. All were over 18 years of age, had remained in the Neurosurgical Intensive Care Unit of a University Hospital for at least one week and had a recorded axillary temperature exceeding 38°C. Written permission from the Ethics Committee of the relevant institution was obtained to allow the research to proceed. Data were gathered between September 2013 and February 2014 using a data collection form developed by the researchers. Descriptive statistical methods frequency, average, standard deviation were used for the data analysis.Results: 72 out of 180 40% patients admitted to NICU between 2010 and 2014 developed a fever. The principal interventions by nurses to maintain fever control were identified as: giving an antipyretic agent by doctor’s order 98.6% , using a cooling electrical fan 88.9% , giving a tepid bed bath 75% and adjusting the room temperature or removing blankets 72.2% . The most frequently used antipyretic agents were identified as metamizole sodium 27.8% , a combination of metamizole sodium and paracetamol 26.4% or paracetamol alone 16.7% . Conclusion: From the study data, it was determined that the most frequent method used to provide fever control in NICU patients was pharmacological, and that the most frequently used nursing interventions were attempts at physical cooling

Keywords:

Fever, neurosurgical intensive care unit, nursing interventions, physical cooling methods,

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