Abstract | Infekcija je razmnožavanje patogenih mikroorganizama u ljudskom organizmu. Infekcija kirurškog mjesta je najčešća bolnička infekcija kirurških bolesnika. Najčešći uzročnici su gram pozitivni koki i gram negativni bacili, enterobacteriaceae. Kada govorimo o ginekološkoj kirurgiji najveći razvoj doživjela je u 19. stoljeću kada se odvojila od abdominalne kirurgije. Ginekološkim operacijama može se pristupiti abdominalnim i vaginalnim putem, endoskopski (laparoskopski) te laparovaginalno.
Rad medicinske sestre u prevenciji infekcije je značajan. Njene intervencije su bitne u prijeoperativnom, intraoperativnom kao i u postoperativnom tijeku Na prvom mjestu je poštivanje mjera asepse odnosno provedba dezinfekcije i sterilizacije. Prije svakog kirurškog zahvata potrebna je primjena antimikrobne profilakse koja dovodi do znatnog smanjenja postoperativnog morbiditeta i mortaliteta. Najčešće se primjenjuju cefalosporini I. generacije. Kvaliteta prijeoperativne pripreme najviše ovisi o hitnoći zahvata. Ako je on planiran medicinska sestra ima dovoljno vremena da provede sve potrebne intervencije uključujući: kontrolu vitalnih funkcija, laboratorijske pretrage, EKG, priprema probavnog trakta, razgovor s pacijenticom u cilju edukacije i otklanjanja straha. Kada se radi o hitnom zahvatu provode se samo najnužniji postupci. U preoperativnoj pripremi jako je važna psihološka priprema, budući da je ženama odlazak na ginekološke operacije posebno stresan. U cijelom procesu bitno je uključiti i partnera pacijentice jer je on jedan od najvažnijih faktora za psihološki oporavak. U intraoperativnom tijeku uloga medicinske sestre je priprema operativnog polja, primjena antibiotske profilakse, kontrola glukoze u krvi i prevencija hipotermije. Postoperativni tijek je obilježen njegom kirurške rane te edukacijom pacijentice i obitelji.
Čestom promjenom smjernica u medicini javlja se potreba za trajnom edukacijom medicinskih sestara. Jedino takvim načinom može se osigurati najkvalitetnija zdravstvena zaštita za pacijente.
Ključne riječi: infekcija, infekcija kirurške rane, prevencija, edukacija, ginekologija |
Abstract (english) | Infection is multiplication of pathogenic microorganisms in human organism. Surgical infection is the most common hospital infection of surgical patients. The most common causes are gram positive cheek and gram negative bacilli, enterobacteriaceae. When we talk about gynecological surgery, the greatest development was experienced in the 19th century when it was separated from abdominal surgery. Gynecological operations can be accessed by abdominal and vaginal routes, endoscopic (laparoscopic) and laparovaginal.
The work of nurses in the prevention of infection is significant. Her interventions are important in the preoperative, intraoperative as well as in the postoperative course. First of all, it is respecting the aseps, that is implementation of disinfection and sterilization. Prior to any surgical procedure, antimicrobial prophylaxis is required which results in a significant reduction in postoperative morbidity and mortality. Most commonly used cephalosporins of the 1st generation. The quality of preoperative preparation depends largely on the urgency of the procedure. If a planned nurse has enough time to carry out all the necessary interventions including: control of vital functions, laboratory tests, ECG, preparation of digestive tract, interview with a patient for the purpose of education and elimination of fear. When it comes to emergency procedures, only the most urgent procedures are implemented. In preoperative preparation, psychological preparation is of great importance, as women's departure from gynecological surgery is particularly stressful. Throughout the process, it is also important to include a patient partner because it is one of the most important factors for psychological recovery. In the intraoperative course of the nurse's tasks are preparation of an operational field, application of antibiotic prophylaxis, blood glucose control, and hypothermia prevention. The postoperative course is characterized by surgical wound healing and patient and family education.
By frequent change in the direction of medicine, there is a need for continuing education of nurses. Only in such a way can the best quality health care for the patients be ensured.
Key words: infection, surgical wound infections, prevention, education, gynecology |