Relevance. Every year, 1.5 to 3 million patients are faced with problems with bedsores (70% of patients who have bedsores are elderly, 66% are elderly with hip fractures, 33% are in intensive care units, 25% - people who are at home (bedridden patients)). [1]
Pressure ulcers remain the chief complications of prolonged hospitalization, specifically in situations of poor nutrition, increased moisture on the skin (e.g., incontinence), prolonged pressure, and compromised sensory stimuli . Pressure ulcers increase the cost of hospitalization, increase patient morbidity and mortality, and play a significant role in the spread of infection in the clinical агеа. [2,4]
Nursing care is a complex and responsible process that requires knowledge and skills, and professional nursing care is, first of all, the highest quality care. [3].
Objectives: to identify the factors that influence the development of pressure sores and provide nursing care for the prevention of pressure sores.
Materials and methods. The study was conducted on the basis of the Regional Hyperbaric Oxygenation Center of T. Orynbayev in the department of palliative care and nursing care. The total number of patients was 213: of them, with chronic cerebral circulation disorder (CCCD) - 94, and oncological patients - 118.
Factors for inclusion: patients who were on inpatient treatment who received treatment at the department for three months, at risk of developing bedsores 10 or more on the Waterloo scale, who had no bedsores at the time of the study.
The study involved 10 seriously ill patients: with CCCD and oncological disease, of which 6 men and 4 women.
In the course of the study, various sources of literature on the topic were studied, a history of patients was collected, and work was conducted with the history of the disease.
In the department of palliative care and nursing care for the prevention of decubitus, hygiene measures were carried out, the schedule of changing the position of the patient's body in bed was observed, and rational nutrition (a protein diet) was observed. Patients were trained in a set of physical exercises and passive gymnastics, used antidecubitus mattresses, which constantly change pressure on the body at different points, due to blowing and inflation of air every 7 minutes in special cells of the mattress; foam mattress; soft pillows made of foam rubber, rollers.
Result and discussion. The following results were obtained during the study. During the follow-up period, out of 10 patients no bedsores were formed.
The most important characteristics of the medical and social portrait - sex, age, education, did not have an important influence. Effectiveness was influenced by effective interaction with the patient, benevolent attitude to him and nursing care, according to five stages.
Conclusions: Thus, three main factors leading to the formation of pressure ulcers were identified: 1. prolonged (more than 1-2 hours) pressure in the area of the bony projections; 2. damage to soft tissues from friction; 3. tissue damage from shear.
Nursing was provided in accordance with five stages, so that bedsores were avoided.
Bibliography
- Antyushko, Т.Д. Care for pressure sores: nursing competence / Т.Д. Antyushko // Main nurse. - 2011. - №6. - P. 99-102.
- Antyushko, TD Organization of nursing care for the prevention of pressure sores / T.D. Antyushko // Sisterhood. - 2010. - №6. - P. 21-24.
- Buryka, N.N. Use of innovative technologies in the care of seriously ill patients. Application of the products of the company Paul Hartmann / N.N. Buryka // Sisterly business. - 2011. - №3. - P. 46-48.
- Osipova, V.L. Innovative technologies in caring for a seriously ill patient: Textbook / V.L. Osipova, S.G. Pavlova. - M., - 79 pp.