Delirium i praktyki pielęgniarskie oparte na dowodach naukowych: Aktualne informacje o pandemii Covid-19
DOI:
https://doi.org/10.15225/PNN.2022.11.2.5Abstrakt
Delirium to złożony zespół neuropsychiatryczny charakteryzujący się ostrym początkiem zaburzeń poznawczych, uwagi, dezorientacji i zmianą poziomu świadomości. Delirium to poważny problem zdrowotny, występujący w każdym wieku i w każdym stanie zdrowia, w wielu miejscach — od oddziału ratunkowego po salę operacyjną. Objawy delirium mogą pojawić się w ciągu kilku godzin lub dni i trwać dłużej niż miesiąc. Pielęgniarki odgrywają ważną rolę w diagnozowaniu delirium i zarządzaniu procesem, stosując w opiece nad pacjentem praktyki oparte na dowodach naukowych. Testy przesiewowe i diagnostyczne wykorzystywane do klasyfikacji ryzyka delirium i diagnozowania powinny być stosowane przez pielęgniarki, które opiekują się pacjentem w dzień i w nocy. Wysoka śmiertelność w grupie chorych z delirium, długi pobyt na oddziale intensywnej terapii lub w szpitalu prowadzą do wysokich kosztów utrzymania. Częstość występowania delirium u pacjentów z Covid-19 wzrosła. Czynnikami wyzwalającymi delirium w pandemii Covid-19 mogą być: dystans społeczny i izolacja społeczna, praktyki głębokiej sedacji, wysoka gorączka, przedłużona wentylacja mechaniczna, opóźniona ekstubacja z powodu lęku przed rozprzestrzenianiem się aerozolu, niewłaściwa ocena bólu, percepcja psychologiczna (masowa śmierć), dysfunkcje wielonarządowe. Wiadomo, że stosowanie pakietu opieki ABCDEF (ocena bólu, próby spontanicznego przebudzenia i oddychania, wybór leków, monitorowanie/zarządzanie w przypadku delirium, wczesne ćwiczenia/mobilność i wzmocnienie pozycji rodziny) jest skuteczne w postępowaniu w przypadku delirium. Zaleca się stosowanie pakietu opieki ABCDEF w leczeniu delirium u pacjentów z Covid-19. W niniejszym przeglądzie uwzględniono oparte na dowodach naukowych praktyki w zapobieganiu delirium i opiece pielęgniarskiej w pandemii koronawirusa (SARS-CoV-2) dotykającej cały świat. (PNN 2022;11(2):74–82).
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