Журнал сестринского дела и ухода

????: ????? ????? ???????????????? ?????? ?????????? ???????? ???????? ? ???????? ????????????? ?????????? ????????????????? ????????????? ? ??????? ???????? ??????????? ??????? ? ?????????-??????? ????????????.
??????: ??? ???????? ????? ??? ??????????? ??????? ?????? ???????????? ????????? ????. ??????-???? ?????? PubMed ? Science Direct ??? ??????????????? ????? ? ????????? ??????? ???? ???????????? ??? ????????? ????????????????? ??????, ??????????? ? ????? ???????????????? ??????. ?????? ???????? ?? 46 ????????????????? ?????? ? ??????? ???????? ??????????? ??????? ? ?????????????? ????????? ????????? ? ??????????. ????????????? ??????????? ?????????? ? ???????????? ?????? ? ???????? ????????????? ??????? ??? ?????? ??????. ?????? ?????? ?????????? ? 10 ?????? 2018 ???? ?? 21 ?????? 2019 ????.
??????????: ???? ??????????????? ????? ?????????? ?????? ??? ???????? ????, ????????? ? ???? ????????????. ????? ???????? ???? ???????? ? ???? ??????????????? ??????, ?????? ???????? ??????????? ??????? ? ??????????? ????????. ?????? ????????? ????? ???????? ??????????????? ??????. ??????????? ???????????? ????????? ?? ??????????????? ?????? ? ???????? ??????????? ???????. ? ?????? ??????????????? ??????? ???????? ????????? ???????, ??????? ???????? ??????, ??????, ??????????? ? ???? ? ?????????????????. ?????? ????????? ???? — ?????? ???????? ??????????? ???????. ????? ???????? ?????? ???????????? ???????????, ??? ???????? ??????? ???????? ?????? ??????????? ??????? ??? ?????????-??????? ????????????. ????????? ???????? ????????? ???? — ??????????? ???????? ?????????. ? ?????? ???? ???? ??????????? ???????????? ?????????? ??????????? ???????? ?????????. ???? ???????? ??? ???????, ??????? ?????? ?? ??????????? ???????? ?????????-???????. ? ??? ????????? ?????????, ??????? ????? ? ??????????? ?????????????.
?????: ? ?????, ?????????? ???????? ?????????-??????? ???????????? ? ??????????????? ? ?????????? ??????????????? ???????, ???????? ??????????? ??????? ? ????????????????? ???????? ????????? ? ?? ??????????? ????????.

???????????: ?????? ????????? ???????????? ?? ???????????? ???? ? ???????, ??????? X, ?????? ????? ?????????, ?????????????? ??? ??????? ?????????? ??????????? ???????? ? ??????????????? ???????? ?? ????????? ????????. ????????? ? ??????????? ???? ????? ??????????? ??? ?????????? ????????? ??????? ?????? ? ?????????? ???????????????? ??????????????. ??????????? ????????????????? ?? ??????? ?????, ??? ???????????? ??????? ????????? ???????, ?? ???????? ?? ??????????????, ?? ?????????? ?????????.
??????: ??????????? ?? ???????????? CHAT ???? ??????????? ??? ?????????? ?? ??????????, ?????????? ?? ???????? ? ????? ????? ??????????????? ??????????? ????? ? ???????????????? ??? ???????????? ???????????. ???? ?????????? ?????? ?????????????? ??? ????????????, ??? ? ???????????? ??????????? ??????????? ????? ??? ???????? ?????? ?????????? ? ???????? ???????????? ??????? ????????, ???????, ?????? ? ???????.
??????????: ????? ????? ????????? ???????? ????????? ???????????? ?????????, ?????????? ?????, ???????????????? ?? ????????, ? ?????????????? ???????????????????? ???????????, ?????????? ???? ?????? ??????? ???????????????.
?????: ??????????? ????????? ???????????? ????? ???????????????? ?????????????, ??? ???????? ? ????? ???????? ???????????? ???????.

????????????? ???????? ???????????? ???? ???????? ??? ?????? ???????? ? ????? ?????. ???????? ????????? ????????? ?????? ????????? ????????? ? ????????? ????, ??? ????????? ? ???????, ? ??? ??????? ?? ??????? ?????????, ??????? ????? ???? ????? ? ??????? ?????????????? ????????, ?????, ?????????, ?????????? ????????????? ?????? ? ?????? ??????????? ? ?????????? ????????. ????? ???????????? ???? ?????? ???????? ??????????? ? ??????? ???????????? ????????????? ?? ????????????????? ????????? ????????? ????? ????????????? ?????????.

???? ??????? ????????????? ??????????????? ? ??????????? ?????????????????????? ????????????, ? ???? ???????? ???? ???????? ???????? ????????????? ?????????. ?????? ??????? ??????????? ? ?????????????? ??????? ????? ????, ? ??? ?????? 15 ????????????? ????????? ? ????????????????? ? ??????????? ?????? ?????????????? ???? ????????? ???????? ???????????????? ???????. ?????? ????????????? ????? ????????????????? ??????????? ??????????, ? ??????????? ?????? — ???. ?????? ?????????????? ? ?????????????? ??????????????? ?????? ??? ?????????? ???? ?????? 21. ?? ??? ????????????????? ??????? ???? ???? ?????? ? ?????????????? ???????????? ?????????? ?????????, ? ???? ???????? ???? ????????? ? ?????????????? ??????????????? ?????????? t-???????? ????????? ??? ?????? ?????????? 0,05.

??? ???????????? ??????????, ??? ????????? ??????? ??????????? ???? ????????????? ?????????. ????????????? ???????? (??? ? ?????????????????, ??? ? ? ??????????? ??????) (33%) ?????????? ??????? ????????? ??????? ?? ????????. ?????????? ???????? ????? ????????????, ?????????? ??????? ??????? ????????? ??????? ? ????????????????? ?????? (40% ????????? ?? 26,7%) ?? ???? ???????? ?? ????????????????? ? ?????????????????? ??????? ?? ????????? ? ??????????? ??????? (26,7% ??????????? ?? 33,3%). ??? ?????????? ????????????? ??????? ???????????? ?????????????, ?? ??????? ???????? ??????????? ????????????????? ?????? ????????? 0,08; ????? ??? ? ??????????? ?????? ??? ????????? 0,15 ??????????????. ????????? ?? ?????? ???????????? ??????? ? ?????? ??????????? ????? ?????????? ????????????????? ? ??????????? ????? (p=0,514).

???????? ?????????????? ??????? ?????? ???? ??????? ?? ??????? ????????? ????????? ? ???????????????? ?????. ??????????, ??????????? ? ??????????????? ??????? ???????? ?????????????? ???????, ?????? ???? ??????? ? ????????????? ?? ????????, ????? ????????????? ???? ???????????????? ??????????.

Aim and objectives: This study aimed to determine the efficacy of nurse led insulin protocol to control blood glucose among critically ill patients.
Background: Hyperglycemia is a common problem among critically ill patients in the ICUs that consistently linked with worsened clinical outcomes in various groups of patients. Thus, ensuring effectiveness, safety and a high-quality glycemic control can be achieved with a protocol that combining continuous intravenous insulin with frequent bedside blood glucose monitoring.
Design: Quasi-experimental design was used in this study.
Methods: This study was conducted in the ICU departments at Alexandria Main University Hospital on 60 newly admitted hyperglycemic critically ill patients. They randomly assigned into two groups; control group and intervention group. The nurse led insulin protocol was applied among the study group, while the control group managed by the routine ICU management.
Results: The hyperglycemic mechanically ventilated patients who were managed by the nurse led insulin protocol experienced lower mean blood glucose level and lower glucose variability than those who were managed by routine management of the ICUs.
Conclusion: The nurse led insulin protocol was an effective to control blood glucose level among critically ill patients. Relevance to the clinical practices: nurses’ led insulin protocol has strongly and consistently linked with better glycemic control and improved clinical outcomes in various groups of patients. Implementation of nurse led protocols increases nurses’ autonomy; a concept that has been associated with increasing their perceptions of improved quality of care and job satisfaction.

????: ????? ??????? ???????????? ???? ?????? ? ??????? ? ???????? ????????? ? ????????? ??? ? ??????? ???????? ?????????? ?????? ??????, ???????, ??.
???????????: ???????????-?????????? ???????????? ???? ????????? ????? ????????? ? ??????? ???????? ?????????? ?????? ?????? ???????, ??. ????????? ???? ???????? ?? ?????? ????????????? ? ?????????????? ?????? ????????? ???????. ?????? ???? ??????? ? ??????? ?????????????? ????????????? ??????.
??????????: ? ???????????? ??????? ??????? 55 ???????, ??????? 7,3% ?????? ? 92,7% ??????. ????? ?????? ? ???????? ?????????? ???? ?????????? ? ?????????, ??? ????????, ??? ??????? ??????? ?????? ?????????? ???????? 82,02% ?? ??????????? ??????????? 12,347%, ? ?? ????? ??? ??????? ???????? ????????? 42,42% ?? ??????????? ??????????? 10,948%. ??????????? t-???? ??? ???????? ??? ????????? ?????????? ???????? ?????????? ? ????, ??? ???????? ???? BLS, ??? ???? ???????? p = 0,010.
??????????: ??????? ????????????, ??????????? ? ??????? ???????? ?????????? ??????, ???? ????????????? ?? ??????? ? ???????? ????????? ? ????????? ???. ??????????, ??-????????, ? ???????????? ??????? ????????, ??? ? ????????? ???? ?????? ???????? ??? ?? ????????? ?? ????????. ???????????? ????? ???????????, ??? ????????? ?????? ???? ?????????? ??????? ??????? ???.

???????????: ? ????????? ???? ??????????? ??????? ???????? ? ?????????? ????? ?????????? ??????? ? ????????????? ?????????, ?????????? ???????. ???????? ???????? ????? ?? ??????????????? ??????????, ??????? ??????? ?????? ?? ??????????? ??????????? ??????? ??????????, ??????????? ???????. ?????? ?????????? ???????????? ?? ????????????? ???????? ??? ??????????. ???? ?? ??????? ???????? ????????????? ? ??????? ????????????? ????????? ? ???????????? ????????????? (ADL) ?????????, ?????????? ???????, ??? ???????????? ????? ?? ?????????????? ????????? ???????????? ????? ?? ??????????, ?????????? ???????????? ????? ????????. ????? ??????? ???????????? ???????? ???????? ?????????? ????? ?????????, ??????? ????????????? ????????? ? ??????????? ?????????????? ????????????? (FIM) ?????????, ?????????? ???????.

??????: ? ???? ??????????????? ???????????? ?? ??????? ??????????? ?????? ? ???????????????? ?????????, ????????????? ? ?????? ????? ? ??????, ? 1 ?????? 2018 ???? ?? 31 ?????? 2019 ????. ?? ??????????? ??????? ?? ??????? ?????? ? ???????? ? ????, ???? ????????, ????? ????????, ?????? ????????????? ????????? ? ??????? ??? ?????????? ????????. ????????? ????????????? ??????, ?? ??????? ?????????? ????? ????????? ? ????? ??????????? — ??????? ????????????? ????????? ? ??????????? FIM.

??????????: ??????????? ??????? ???????? ?? 22 ????????? ? ????????? (??????? ???????? (?????? ????????) - 16; ? ?????????? ???????? (?????? ??? ????????) - 6). ??? ???????? ?????? ????????????? ?????????, ?? ????? ???????? ?? ???? ???????? ???????? ????????. ?????? ?????????? FIM ? ???????? ? ?????? ? ????????? ???? ??????? ????, ??? ? ?????? ??? ????????.

??????: ??? ???????? ?????????, ?????????? ???????, ??????????? ? ???????????????? ????????? ?? ????? ??????????????, ????????? ????????? ? ????????? ? ??? ???????? ?????????? ?????????: ?????????? FIM ??????????? ????; ?????? ????????????? ????????? ??????????? ?? ??????????? ????? ????????; ? ??????? ??????? ????????????? ????????? ? ????????? ? ????????? ? ????????? ????????? ????? 1 ?????.

????: ????? ??????? ???????????? ???????? ????????? ? ????????? ??????? ?????????????? ???????? ??? ????????????? ???????????? ?????????-??????? ?? ?????????? ????????.
??????: ??? ???????????? ???? ???????????? ??? (100) ????? ???????? ????????? ? ??????????????? ??????? ???????????? ???? ? ?????????? ???, ???????, ??????, ???????. ??? ???????? ????? ??????. ???????????? ???????????? ???????????? ???? ??????, ??????? ???? ??????? ??????? ???????? ??? ????????? ?? ???????.
??????????: ???????????? ????????????, ??? 80,9% ???????????? ????? ???????? ???????????? ???? ???????? ?????????????????, (68,1%) ?? ???? ??????????????? ?????, ? ?? ????? ??? (68,1%) ???????????? ???? ?????????? ??????? ?????? ?????????-???????, (53,2%) ???????????? ???? ??????????? ?????????? ?????, (49,0%) ???????????? ???????, ??? ??????? ? ????????????? ?????? ????? ?????? ?? ?? ????????????, (85,1%) ???????????? ???? ????????????? ?????????? ? ???????? ??????????.
??????????: ? ??????????, ??????????? ????????? ?????????????? ??????, ??? ??????????? ??????????? ?????????, ?? ????????? ??????????? ???? ??? ???????????????? ?????????, ????????? ????????? ?? ??????, ????? ?????? ?? ???????? ??? ????????, ?????????? ???????????? ?? ?????? ????????? ?????, ??????? ? ????????????? ???? ? ???????????? ??????? ???????? ?????????? ??????. ?????????? ???????? ?????????????? ???????????? ??????? ????????? ? ??????? ???????? ??? ?????????-?????????.

???????????: ????? ??????? ???????????? ???????? ???????? ?????????? ???????? ????? ?? ?????????, ??????? ????????????????? ???????? ? ??????? ????????? ?? ???????????? ???? ? ????????? ????. ??? ????????? ????? ??????????? ??????????? ?????? ??????? ???????????? ??????????????? ????? (??) ? ??????????????, ?????????? ? ????????? ????? ??????? ????????? ?? ???????????? ????.
?????: ??? ???????????? ??????, ???????????? ?????? ???????????, ????????? ?? ??????????? ??????????? ?????? ?????????-???????????? ???? ??????????? ?????? ?????????? ??????????????? ????????, ????????????????????? ???????????? ?????????????? ???????? ? ?????-?????. ?????? ???? ??????? ? ???, ??????????? ??????? ?? ???????????? ??????????? ??, ??????????????, ????????? ? ????????????? ????? (??????????????) ? ??????? ????? ???????. ??? ??????????? ??? ?????? ???? ???????????????? ? ?????????????? ??????????? ????????????? ????????? ????? ? ????????. ????????????? ???????????????? ??????? ??? ?????? ?????????? ???????????? ?? ????? ???, ??????????? ??????? ?? ???????????? ??????????? ??, ??????????????, ????????? ? ????????????? ?????.
??????????: ???????????? ??????????, ??? ??????? ?????? ?? ? ??????? ????????? ?? ???????????? ???? ?? ????????????? ????, ??? ????? ?????? ??????? ????????? ???????????? ??????? ??????????.
??????????: ? ???????????? ???????????? ???????????? ?????????? ?????????? ???????????? ????? ? ??????????? ??????????? ? ?????.

???????????: ? ???? ???????? ??????????? ?????? ????????? ?????? ?????????? ??????????????? ???????????? ????????????????? ???????????, ????? ??????? ????????? ????? ??????? ??????????? ??????????? ?????????, ???????????? ????? ?????, ????????? ??? ???????? ????????? ???????????? ??????????? ?????? ????????? ? ?????????. ?????????????? ???????????? ????? ???????? ?????????? ????? ????????????????? ??????????? ????????????? ?? ??? ? ???. ??????? ?????, ????? ????????? ????????? ????????? ???? ?????? ?? ????????? ? ?????????? ? ??? ? ??? ? ? ???, ??? ??????????? ? ???????????????? ????????????.
?????: ???????? ?????????? ?????? ??????????? ?????? ??????? ????????? ???????? ??? ?????????, ? ?? ?????? ?? ?????????? ???????????????? ???????????? ? ????????? ? ?????????? ? ??? ? ??? ??????????? ? ??????? ?????? ?? ? ????? ????????????.
?????????: ????? ??????? ??????? 36 ?????????? ?????????????????? ?????????. ??????? ???? ?? ???????????? ???????? 8,7, ? ????? ???????????? ?????????? ?? 10,1. ??????, ????????? ? ??? ? ?????????? ? ?????????? ? ??? ? ???, ??????????? ?????????? ????? ?????????? ????? (p = 0,0001 ? 0,002 ??????????????).
??????????: ????????? ?????? ?????????? ????????????????? ??????????? ??? ? HBV, ? ?????????? ????? ???????????? ???????????? ???????? ???????????? ???????? ?????????, ????? ??? ????? ?????? ????????????? ? PEP ? ??????????? ????? ????????????????. ?????????? ?????????? ? ????????? PEP ??????? ?? ???????????? ???????? ?????????? ??????????? ????????????.

???????????: ??????????? ??????? ????????? ? ????????? ????????? ?????????? ?????? (???) ????? ???????? ???????? ??? ?????????????? ???????? ? ???????????????? ??????????. ????? ??????? ???????????? ???? ??????????? ???????????????? ??????????, ??????? ?????????????? ? ??????? ?????????????? ? ????????? ??????????? ??????? ? ??????? ????????? ??? ? ???????????????? ??????????? (???).
??????: ??? ???????? ??????????????? ????? ??????? ??????? 796 ????????? ? ????????????????? ????????, ??????????? ? ??? ? ??????? 3 ??????? ? ???? ????????? ???????? ??????. ????????????? ???????????? ????????, ??????? ??? ?????? 100 ?? ??. ??., ???? ?????????? ??? ???. ????? ???? ???????? 318 (39,95%) ??????? ? ????????? ??? ? ???. ????????? ???????????? ??????????? ???? ??????? ??????????, ????????????????? ?????????? ? ????????? ??????????? ??????? ? ??????? ??????????????.
??????????: ??????? ?????????? ? ??????? ?????????????? ???? ??????????? ???? ? ????????? ? ???, ??? ? ????????? ? ??????????? ????????????? ???????????? ?????????. ?????????? ????? ????????? ???????????? ????????, ??? ????????? ? ????????? ?????????? ?????? ??????????? ???????? ?? ?????????? ? ?????????? (p=0,002) ? ??????? ?????????????? (p<0,001).
??????????: ??? ?????????? ??????????????? ? ???, ??? ?????? ????????? ? ????????? ?????????? ?????? ?????????? ???? ??????????? ??????????? ?????? ?? ?????????????? ????????????? ????????? ? ???????????????? ????????? ? ????? ?????????????? ?????????? ??????????????? ???????????, ? ????? ???????? ?????? ??????????.