CLINICAL PROCESS
When the patient comes to the intensive care unit, he is greeted by the nurse and staff. The patient's file is arranged and the documents are filled in completely and completely. The patient is accepted through the automation system. A wristband with a hospitalization barcode containing the identity information is attached to the patient's arm. The patient's clothes and jewelry are taken off and handed over to his relatives or, if there are no relatives, to the hospital police. The patient is monitored and vital signs are taken. It is recorded in the nurse observation form. The doctor is informed. If there is no vascular access, it is opened, if it is open, it is checked whether it works. Requested tests are taken and sent to the laboratory. Physical examination is done by the physician, O2 is inserted according to the necessary monitoring and need. If necessary, a foley catheter is attached to the patient. Patient treatment is prepared and applied in accordance with the order. Nursing services patient pre-evaluation form is filled. If consultation is requested from the patient, a consultation form is sent to the necessary units. Automation entry is made. For imaging examinations such as x-ray and ultrasound of the patient, an appointment is made from the relevant units and the patient is sent. Nursing care is applied and recorded in the patient care process form. Telephone numbers of first-degree relatives are taken for communication.
MONITORING
The patient, who is admitted to the intensive care unit, is monitored after being taken to the bed. The monitor monitors the measurements of pulse, blood pressure, respiratory saturation and other invasive interventions that need to be monitored. It is recorded on the nurse observation sheet.
FOLLOW-UP OF THE PATIENT IN THE VENTILATOR
The patient's intubation is decided by the physician after examination and evaluation of blood gases. The patient, whose intubation is decided, is intubated by providing appropriate sedation and is connected to the ventilator. The ventilation mode is selected according to the patient's condition. It is aspirated as needed. The patient's oxygen saturation is constantly monitored. Electrolyte, intake and output, blood gas are continuously monitored. Frequent positions are given. Humidifier and bacteria filter are used to moisten the airway. The patient's head should be elevated 45 degrees, Ambu should be ready at the head of the patient. The ventilator should be maintained at regular intervals.
SEDATION AND ANALGESIA APPLICATION
In the intensive care unit, sedative agents are applied to relieve the patient's agitation and anxiety and to allow him to tolerate the treatments and interventions more easily. Benzodiazepines, Midazolan, Propofol, Neuroepileptics are administered to create sedation in the intensive care unit. Neuromuscular blockade and sedation of the patient are planned and followed up by the anesthesiologist when necessary.
PATIENT FOLLOW-UP WITH SCORING SYSTEM
The appropriate one among the APHACHE, SAPS, PRISM scoring systems is made by the physician following the patient.
PRESSURE WOUND FOLLOW
It is considered risky when the patient is admitted to the intensive care unit. Evaluation is made according to the "Braden Pressure Sore Evaluation Scale" in the "Patient Pre-Assessment Form". According to the score obtained, the patient's pressure ulcer evaluation is continued on a weekly/daily basis. The bed of the patient with a high risk of pressure ulcers should be an air mattress / decubitus mattress. The sheet should be taut and smooth. The patient should be positioned at least every 2 hours. If a pressure sore has occurred; The part with pressure sores is oxygenated by being supported with pillows. Dressings are made with appropriate wound care products. In case of a wound occurs for the purpose of tracking pressure sore data, the department nurse makes the Pressure Sores Notification with their own passwords, using the "Quality Management Indicator Cards Module" created over HIMS.
INVASIVE PROCEDURES
The physician is responsible for the application of invasive procedures such as oral-nasal intubation, central venous catheter, etc. vascular and parenteral nutrition catheter applications, CVP catheter insertion and follow-up, Arterial pressure catheter insertion and follow-up in intensive care units. The follow-up of the invasive procedures that are monitored are recorded in the patient file by the nurse.
REHABILITATION PROCESS
In the rehabilitation process of the patient, whose follow-up and treatment continues in the intensive care unit, it is aimed to correct the deteriorated functions of the patient, to increase his self-care and quality of life. In this direction, cooperation is made with the Physiotherapist, Dietitian, Psychologist, Social Worker and the patient's family.
NUTRITION TRACKING
The nutritional need for the patient is determined by the physician according to the protocols of the relevant unit. The nutritional support required to meet the need (Parenteral TPN solution or enteral nutrition products) is decided together with the Dietitian. Nutritional support is continued according to the patient's routinely evaluated laboratory findings and other clinical evaluation protocols. This process is followed by the physician and dietitian.
TERMINAL PATIENT FOLLOW-UP
The aim of the patient follow-up in the terminal period is to increase the quality of life of the patient who is in the process of death, to reduce pain and other health problems, or to reduce pain and other health problems.