Internistic patient care at emergency department and nurse role in Slovenia

Uvod: V okviru bolnišnic se nujna medicinska pomoč zagotavlja v urgentnih centrih, kjer poteka neprekinjena, 24-urna, oskrba pacientov. Internistična prva pomoč je del urgentnega centra v Univerzitetni klinični center Ljubljana, kjer so obravnavani pacienti, ki zaradi poslabšanja kronične bolezni ali akutno nastale nove bolezni potrebujejo takojšnjo obravnavo. Obravnavani so pacienti z urgentnimi internističnimi stanji, ki prizadenejo dihala, srčno žilni sistem, prebavila, sečila, bolezni presnove in acidobazno ravnovesje. Nujno oskrbo pogosto potrebujejo starostniki in pacienti s kroničnimi boleznimi. Namen: Namen diplomskega dela je s pomočjo strokovne in znanstvene literature opisati obravnavo pacienta v urgentnem centru ter predstaviti vlogo medicinske sestre. Cilj diplomskega dela je predstaviti Internistično prvo pomoč in ukrepe medicinske sestre za večjo varnost pacientov. Metode dela: Za nastanek diplomskega dela je bila uporabljena deskriptivna metoda dela s pregledom domače in tuje strokovne literature. Literatura je bila iskana v slovenskem in angleškem jeziku v podatkovnih bazah Medline, Science Direct, CINAHL, na iskalniku PubMed ter na spletnih portalih Google Učenjak in DiKul v časovnem obdobju med januarjem 2021 in decembrom 2021. Rezultati: Povsod po svetu se srečujejo s preobremenjenostjo urgentnih oddelkov. Vseh pacientov, ki prihajajo na urgenco, ni možno oskrbeti hkrati, zato se uporabljajo različni triažni sistemi, na Internistični prvi pomoči Manchesterski triažni sistem. Izvajajo ga za triažo usposobljene medicinske sestre. Nadzor vitalnih znakov in zgodnje odkrivanje odstopanj vpliva na hitrejše odkrivanje sprememb zdravstvenega stanja in s tem nudi hitrejšo zdravstveno oskrbo. Sodobna urgentna zdravstvena oskrba pacienta zahteva timski pristop in dobro komunikacijo, da se tako lahko zagotovi najvišjo stopnjo varnosti pri obravnavanih pacientih. Razprava in zaključek: Po svetu narašča število obravnav pacientov v urgentnih ambulantah in pogosto presega zmogljivosti zdravstvenega tima. Na urgenco prihaja vse več starejših pacientov s kroničnimi obolenji, pri katerih ocena zdravstvenega stanja zahteva več časa, zdravstvena nega je zahtevnejša, na urgenci pa povprečno bivajo dlje. Medicinske sestre s pridobivanjem novih znanj in kompetenc, dobro komunikacijo in sodelovanjem v timu prispevajo k varni in kakovostni zdravstveni oskrbi pacientov.Introduction: Hospitals provide emergency medical assistance at emergency centres where they treat patients uninterruptedly, 24/7. Internist first aid is part of the emergency centre at the University Medical Centre Ljubljana, where patients are treated that require immediate care due to an acute disease or the deterioration of their chronic disease. The unit treats patients with emergency internal medical conditions that damage the respiratory system, the cardiovascular system, the digestive tract, the urinary tract, cause metabolic diseases and affect the acid-base balance. Emergency care is often required by the elderly and patients with chronic diseases. Purpose: The purpose of the diploma thesis is to describe patient care at an emergency centre and present the role of a nurse by means of scientific and scholarly literature. The aim of the diploma thesis is to present first aid provided by internists and the measures taken by nurses to increase the patients\u27 safety. Methods: The diploma thesis was written using the descriptive method with a review of domestic and foreign scholarly literature. The literature was searched in the Slovenian and English language in the databases Medline, Science Direct and Cinahl, in the PubMed search engine, and on the Google Scholar and DiKul web portals in the period between January 2021 and December 2021. Results: Throughout the world, emergency departments are bursting at the seams. Not all the patients who arrive in the emergency room can be treated simultaneously, which is why various triage systems are in usethe Manchester triage system is being used in internist first aid. This system is practised by nurses qualified for triage. Annual average treatment waiting time at the internist first aid unit. Monitoring vitals and detecting abnormalities early can enable us to detect changes in the medical condition sooner and take action faster. Modern patient care requires a team-based approach, which ensures the highest level of safety for the patients receiving care. It is important that we establish good communication in all areas, especially in emergency situations. Discussion and conclusion: Around the world, the number of patients being treated at emergency units is increasing and often exceeds the capacities of the healthcare team. A growing number of elderly patients with chronic diseases are arriving at emergency roomsit takes longer to assess their medical condition, nursing them is more demanding, and they have a longer length of stay, on average. By gaining new knowledge and competencies, establishing good communication, and working in a team, nurses contribute to a safe and quality care of patients