The nursing process in the management of chronic wounds

Kronične rane zbog posebne anatomije i hemodinamskih uvjeta na donjim ekstremitetima vrlo često se opažaju nakon dugogodišnjih simptoma. Smatra se da je kronična rana ona koja uz standardne medicinske postupke ne cijeli i traje duže od osam tjedana. Važno je znati da se kronične rane javljaju kod starijih osoba koje imaju tanku i krhku kožu,slabu cirkulaciju, zato je liječenje kroničnih rana i smanjenje boli presudno za njihov život. Liječenje takvih rana je izuzetno skupo i dugotrajno stoga je važno da rani pristupimo na pravilan način, jer ako ne liječimo kroničnu ranu ispravno nerijetko dolazi do teških i fatalnih komplikacija. Važna je edukacija medicinskih sestara koje skrbe o pacijentima sa kroničnim ranama, važan je tretman kronične rane zato što medicinska sestra svojim znanjem može ubrzati proces cijeljenja kronične rane. Potreban je multidisciplinarni tim i holistički pristup svakom pacijentu. Danas su prisutne različite obloge za tretiranje rana, ali nažalost još uvijek u praksi susrećemo tretiranje rane sa gazom. Cilj ovog rada je prikazati pristup u zbrinjavanju kroničnih rana te prikazati smjernice u prevenciji i liječenju kroničnih rana i pridonijeti smanjenju incidencije i prevalencije kroničnih rana. Provedeno je istraživanje u Općoj bolnici Varaždin u službi za produženo liječenje Novi Marof, ukupan broj ispitanika je 82 (N=82). Istraživanje je provedeno uporabom anonimnog upitnika o stavovima i načinu na koji se rane tretiraju. Rezultati pokazuju kako je i dalje potrebno provoditi edukaciju i podizati svijest zdravstvenim djelatnicima u svrhu prevencije kroničnih rana, posebice dekubitusa koji su zastupljeni u najvećem postotku.Chronic wounds due to the specific anatomy and hemodynamic conditions in the lower extremities are mostly observed after long-term symptoms. It is considered that the chronic wound is one which common medical procedures does not heal and lasts eight weeks. Prevent chronic wound is much easier than cured it. For elders’ people the treatment of chronic wounds and pain reducing is crucial for their lives due to fact that they have thin and fragile skin, poor circulation. The treatment of such wounds is extremely expensive and long –term, so therefore it is important to have early wounds access on proper way, otherwise heavy and fatal complications will occur. It is very important to have educated nurses who cares for patients with chronic wounds, also the treatment of chronic wounds are important because nurses with their knowledge can accelerate the whole healing process. It is necessary to have a multidisciplinary team and holistic approach for each patient. Today we have different types of wounds coverings, but unfortunately in practise we still have treatment of wounds with gauze. The target of this graduation thesis is to present approach of treatments of chronic wounds, show guidelines in the prevention and medical curing and reducing the incidence and prevalence of chronic wounds. Inquiry/Study was carried out in University hospital centar Varaždin, in department for extended treatment Novi Marof, the total number of examinees was 82 (N = 82). The anonymous questionnaire with explained attitudes and the ways of wounds treatment are used for execution of Inquiry/ Study. The results show that education is still necessary; also it is necessary to raise awareness of medical staff with the purpose of prevention of chronic wounds, particularly prevention in decubitus, which is represented in the highest percentage