Zagotavljanje varnosti pacienta z akutno psihozo

Uvod: Akutna psihoza je duševna motnja, ki zahteva takojšnjo zdravstveno obravnavo oziroma hospitalizacijo. Kadar je pacient agitiran, avto- ali heteroagresiven, je potrebno takojšnje ukrepanje. Namen: Namen diplomskega dela je preučiti področje zagotavljanja varnosti pacienta z akutno psihozo z vidika aktivnosti zdravstvene nege. Izpostaviti smo želeli pomembnost vloge medicinske sestre pri zdravljenju in zagotavljanju varnosti pacienta z akutno psihozo na oddelku pod posebnim nadzorom. Metoda dela: V diplomskem delu bo uporabljena deskriptivna metoda s pregledom domače in tuje znanstvene ter strokovne literature o akutni psihozi in obravnavi pacienta z akutno psihozo in varovalnimi ukrepi, objavljene od leta 2010 dalje. Pregled strokovne in znanstvene literature v angleškem jeziku je bil opravljen v podatkovnih bazah Science Direct, CINAHL, Medline ter iskalnikom Pubmed in na spletnih portalih Google učenjak in DiKul. V bazah je bila literatura iskana v slovenščini in angleščini s pomočjo ključnih besed: psychosis, acute psychosis, mental illness, safety measures, AND security measures, agression, acute psychosis AND agression, agitation, acute psychosis AND agitation, psychiatry AND security measures, treatment of the patient AND acute psychosis, therapeutic conversation psihoza, akutna psihoza, duševne bolezni, varnostni ukrepi, akutna psihoza IN varnostni ukrepi, agresija, akutna psihoza IN agresija, vznemirjenost, akutna psihoza IN vznemirjenost, psihiatrija IN varnostni ukrepi, zdravljenje pacienta IN akutna psihoza, terapevtski pogovor. Rezultati: Izvajalci zdravstvene nege imajo pomembno vlogo pri zagotavljanju varnega okolja ter dobrega počutja pacienta, ki ima duševno motnjo, kot je akutna psihoza. Dobro terapevtsko okolje in komunikacija pripomorejo k boljšemu izidu zdravljenja. Uporaba deeskalacijskih tehnik, nadzor in izvajanje posebnih varovalnih ukrepov so del zdravljenja, ki so pomembni za varnost pacienta. Razprava in sklep: Zagotavljanje varnosti pacienta, pri katerem gre za samopoškodovanje ali poškodovanje drugega je primarna naloga izvajalcev zdravstvene nege. Medsebojna komunikacija je temelj dobrega odnosa, da pacient pridobi zaupanje. Varnost ter uporaba različnih metod varovanja so naloge, ki se jih da priučiti samo s stalnim izobraževanjem. Akutna duševna motnja zahteva kompleksno obravnavo v psihiatrični zdravstveni negi in naj bi temeljila na dobri izkušnji za pacienta in njegov najboljši izid zdravljenja. Introduction: Acute psychosis is a mental disorder that requires immediate medical treatment or hospitalization. When a patient is agitated, auto, or heteroaggressive, immediate action is required. Purpose: The purpose of this thesis is to examine the field of ensuring the safety of patients with acute psychosis in terms of nursing activities. We wanted to highlight the importance of the role of a nurse in the treatment and safety of a patient with acute psychosis in a ward under special supervision. Methods: In the diploma thesis we will use a descriptive method with a review of domestic and foreign scientific and professional literature on acute psychosis and treatment of patients with acute psychosis and protective measures, published from 2010 onwards. The review of professional and scientific literature in English was performed in the databases Science Direct, CINAHL, Medline and the Pubmed search engine, as well as on the web portals Google Scholar and DiKul. In the databases, the literature was searched in Slovene and English with the help of key words: psychosis, acute psychosis, mental illness, safety measures, AND security measures, aggression, acute psychosis AND aggression, agitation, acute psychosis AND agitation, psychiatry AND security measures, treatment of the patient AND acute psychosis, therapeutic conversation psychosis, akutna psihoza, duševne bolezni, varnostni ukrepi, akutna psihoza AND varnostni ukrepi, agresija, akutna psihoza AND agresija, vznemirjenost, akutna psihoza AND vznemirjenost, psihiatrija AND varnostni ukrepi, zdravljenje pacienta AND akutna psihoza, terapevtski pogovor. Results: Nursing providers play an important role in ensuring a safe environment and well-being of a patient with a mental disorder such as acute psychosis. A good therapeutic environment and communication contribute to a better treatment outcome. The use of de-escalation techniques, control and implementation of special protective measures are part of the treatment that are important for patient safety. Discussion and conclusion: Ensuring the safety of the patient, which is a harm to self or others is the primary task of nursing. Communicating with each other, so the patient gains trust, is the foundation of a good relationship. Security and the use of different security methods are tasks that can only be learned through continuing education. Acute mental disorder requires complex treatment in psychiatric nursing and should be based on good experience for the patient and his or her best treatment outcome.