İÇ HASTALIKLARI HEMŞİRELİĞİNDE ENFEKSİYON KONTROLÜ
Özet
Sağlık hizmeti ilişkili ve toplumdan kazanılmış enfeksiyonların önlenmesi; hasta güvenliğinin sürdürülmesi, hastanede kalış süresinin ve mortalitenin azaltılması açısından kritik öneme sahiptir. İç hastalıkları hemşireleri; immün sistemi baskılanmış, kronik hastalıklı ve enfeksiyon riski yüksek bireylere bakım vermektedir. Kronik böbrek hastalığı, siroz ve romatoid artrit gibi rahatsızlıklar ile steroid ve biyoterapi ajanlarının kullanımı, immün yanıtta yetersizliğe yol açarak fırsatçı enfeksiyon riskini artırmaktadır. Bu hastalarda enfeksiyon belirtileri sıklıkla atipik seyretmekte, tanı ve tedavi süreçleri gecikebilmektedir. Ülkemizde yaygın olan KOAH vakalarında ise mukosiliyer aktivitenin bozulması ve inhaler steroidler enfeksiyon riskini tetikler. Hücresel ve hümoral immün yanıtı azalan, malnütrisyon riski taşıyan geriatrik popülasyonda da enfeksiyonlar genç erişkinlere göre çok daha ciddi seyreder. Yaşlılarda atipik klinik seyir nedeniyle ateş görülmeyebilir; konfüzyon ve yorgunluk ilk belirti olabilir. Hemşireler, kanıt temelli el hijyeni, profesyonel ağız bakımı, erken ampirik tedavi, aşılama protokolleri ve kateter yönetimi gibi multidisipliner girişimlerle enfeksiyon kontrolünde ve hasta eğitiminde anahtar rol oynamaktadır.
Prevention of healthcare-associated and community-acquired infections is critical for ensuring patient safety, reducing hospital stays, and minimizing mortality rates. Internal medicine nurses care for a high-risk patient population, including immunocompromised individuals and those with chronic diseases. Conditions such as chronic kidney disease, cirrhosis, and rheumatoid arthritis, along with treatments like corticosteroids and biotherapy agents, impair immune responses and increase susceptibility to opportunistic infections. In these patients, signs of infection are often atypical, potentially delaying diagnosis and treatment. In cases of COPD, impaired mucociliary clearance and inhaled steroid use further trigger infection risks. Furthermore, the geriatric population, characterized by decreased cellular and humoral immunity and risk of malnutrition, experiences significantly more severe infections compared to younger adults. Due to atypical clinical courses in older adults, fever may be absent, while confusion and fatigue often serve as primary indicators. Nurses play a pivotal role in infection control and patient education through evidence-based interventions, including hand hygiene, professional oral care, timely empirical therapy, vaccination protocols, and effective catheter management.
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