| Abstract | Oštećenje integriteta kože je prekid anatomskog i funkcionalnog dijela kože ili tkiva pri čemu nastaje rana. Ona može nastati kao posljedica dugotrajnog djelovanja određene kronične bolesti kao što je dijabetes ili arterijska hipertenzija, a ukoliko ne cijeli 6-8 tjedana naziva se kroničnom. U skrbi za bolesnika s oštećenim integritetom kože sudjeluje niz zdravstvenih djelatnika različitih specijalnosti i razina zdravstvene zaštite koji čine multidisciplinarni tim. On utječe na tijek i ishod liječenja te kvalitetu života bolesnika s obzirom na ĉ+čestu prisutnost više različitih komorbiditeta. Važan član tima koji je gotovo u svakodnevnom kontaktu sa bolesnikom je medicinska sestra/tehničar, djelatnik ustanove za zdravstvenu njegu u kući. Ona prema holističkim principima, kvalitetnom suradnjom s liječnikom obiteljske medicine, patronažnom sestrom i obitelji korisnika pruža kontinuiranu zdravstvenu skrb u kući bolesnika. Kako bi zdravstvena skrb bila uspješno evaluirana potrebna je kvalitetna sestrinska procjena stanja bolesnika, pravodobno djelovanje u okviru kompetencija, timski rad, prilagodba uvjeta u kući, poznavanje i osiguranje materijala potrebnih za previjanje rane i trajna edukacija medicinskih sestara od strane stručnjaka koji se bave problematikom rana. Važan zadatak medicinske sestre je provesti edukaciju obitelji o metodama liječenja, pravilnoj prehrani i okolinskim faktorima koji doprinose cijeljenju dekubitusa, venskog ili arterijskog ulkusa te dijabetičkog stopala kao najčešćih vrsta kroničnih rana koje se susreću u kući bolesnika.
Za potrebe ovog rada provedeno je istraživanje čiji je cilj bio utvrdi učestalost kroničnih rana korisnika ustanove za zdravstvenu njegu u kući i metode liječenja koje medicinske sestre/tehničari koriste u svakodnevnom radu. Istraživanje je provedeno u razdoblju od 03. do 30. travnja 2021. godine na ciljanom uzorku od 28 medicinskih sestara/tehničara Ustanove za zdravstvenu njegu „Lekić“ u Varaždinu. Podaci su prikupljeni anketnim upitnikom koji je u navedenom vremenskom periodu bio aktivan na internetu. Obradom rezultata utvrđeno je da je najčešće tretirana rana u kući korisnika ulkus potkoljenice kojeg kao najčešća dijagnoza prati dijabetes mellitus. Prijevoj kronične rane na tjednoj razini vrši se 2-3 puta tjedno, a najčešći DTP koji se propisuje kod dekubitalnog ulkusa je DTP 2, dok se kod ulkusa potkoljenice propisuje DTP 7. Najčešće propisivane obloge u tretiranju rana od strane liječnika su hidrofiber, poliuretanske obloge te hidrokoloidni gel i pasta. |
| Abstract (english) | Impairment of skin integrity is the disruption of the anatomical and functional part of the skin or tissue resulting in a wound. It can occur as a result of the long-term effects of a certain chronic disease such as diabetes or arterial hypertension, and if not the whole 6-8 weeks it is called chronic. A lots of health professionals of different specialties and levels of health care, who make up a multidisciplinary team, participate in the care of patients with impaired skin integrity. It affects the course and outcome of treatment and the quality of life of patients due to the frequent presence of several different comorbidities. An important member of the team who is in almost daily contact with the patient is the nurse, an employee of the home health care facility. According to holistic principles, quality cooperation with the family doctor, the community nurse and the beneficiary's family, she provides continuous health care in the patient's home. In order for health care to be successfully evaluated, a quality nursing assessment of the patient's condition, timely action within competencies, teamwork, adjustment of home conditions, knowledge and provision of materials needed for wound dressing and continuous education of nurses by wound care professionals. An important task of the nurse is to educate the family about treatment methods, proper nutrition and environmental factors that contribute to the healing of pressure ulcers, venous or arterial ulcers and diabetic foot as the most common types of chronic wounds encountered in the patient's home.
For the purposes of this labor, a study was conducted to determine the frequency of chronic wounds of home health care users and treatment methods used by nurses in their daily work. The research was conducted in the period from 3 to 30 April 2021 on a target sample of 28 nurses of the Institution for Health Care "Lekić" in Varaţdin. Data were collected by a survey questionnaire that was active on the Internet during the specified period. Processing the results, it was determined that the most commonly treated wound in the home of the user is an ulcer of the lower leg, which is accompanied diabetes mellitus as the most common diagnosis. Chronic wound dressing is performed 2-3 times a week, and the most common DTP prescribed for decubitus ulcer is DTP 2, while for lower leg ulcer DTP 7 is prescribed. Doctors usually prescribe dressings in the treatment of hydrofiber wounds, polyurethane bandages and hydrocolloid gel and paste. |
