Kolorektal Cerrahisinde Hızlandırılmış Bakım Protokolleri ve Hemşirelik Bakımı

Oz Geleneksel uygulamalar sonucu hastalarin hastanede yatma surelerinin yuksek olmasi ve uzun sure hastanede kalmanin hastalarin iyilesmelerini olumsuz yonde etkilemesi nedeniyle hastanede kalis surelerini azaltmayi amaclayan ve kanita dayali olan hizlandirilmis cerrahi protokolleri olusturulmustur. Bu protokoller ameliyat sonrasi iyilesmeyi hizlandirmak icin ortaya cikmis kanita dayali bir bakim modelidir. Avrupa’da ameliyat sonrasi iyilesmenin hizlandirilmasi anlaminda “ERAS”, Amerika’da ise hizlandirilmis surec anlaminda “fast tract cerrahi” olarak adlandirilir. Hemsirelik bakiminda kanita dayali bir bakimin verilmesi hemsireligin gelisimine, yeni politikalarin ve prosedurlerin kullanilmasina olanak saglamaktadir. Bu derlemede kanita dayali bir uygulama olan kolon cerrahisi icin ERAS protokollerinde hemsirelik yaklasimlari hemsirelerin fonksiyonlarinin bulundugu; preoperatif bilgilendirme, egitim ve danismanlik, preoperatif optimizasyon, tromboembolinin onlenmesi, ameliyat oncesi aclik suresi ve karbonhidrat tedavisi gibi bazi protokoller dogrultusunda ele alinmistir. Sonuc olarak protokolde yer maddelerin cogunda hemsirelik uygulamalarinin yer aldigi saptanmistir.  Bununla birlikte kanit temelli bir uygulama olan ERAS protokollerinin geleneksel uygulamalardan cok daha farkli bir uygulama oldugu gorulmektedir. Bu nedenle hemsirelere ve hemsirelik ogrencilerine ERAS protokolleri hakkinda bilgilendirme yapilmasi onerilmektedir. Ayrica literaturde ulkemizde bu alana yonelik deneysel hemsirelik calismalarinin az oldugu saptanmistir. Hemsirelik bakimina yonelik deneysel calismalarin artirilmasi onerilmektedir. Anahtar Kelimeler: ERAS, Kolon Cerrahisi, Hemsirelik Bakimi Abstract ERAS and nursing care for colon surgery As traditional applications increase the hospitalization durations of patients and consequently have a negative effect upon their healing; accelerated and evidence-based surgical protocols have been developed for decreasing the hospitalization durations. These protocols are an evidence-based care model developed for accelerating the postoperative healing. It is called as “ERAS” meaning “acceleration of postoperative healing” in Europe and “fast tract surgery” in the United States. Providing an evidence-based care in the nursing care paves the way for the development of nursing and the use of new policies and procedures. This compilation embraces nursing approaches in ERAS protocols for colon surgery which is an evidence-based application in accordance with some protocols like preoperative informing, training and consultancy, preoperative optimization, prevention of thromboembolism, preoperative hunger duration and carbohydrate therapy, where the functions of nurses are. As a consequence, it was determined that majority of items in the protocol involved nursing applications. Additionally, it is seen that evidence-based ERAS protocols are much more different than traditional applications. Thus, it is recommended to inform nurses and nursing students about the ERAS protocols. It is also seen that there is a limited number of experimental nursing studies on this subject in literature in our country. It is recommended to increase the number of experimental studies on nursing care. Keywords: Colon Surgery, ERAS,  Nursing Care