Hemşirelerin Flebite İlişkin Bilgi Düzeylerinin Periferik İntravenöz Kateter Değişimine Etkisinin İncelenmesi

Abstract

Amaç: Çalışma, hemşirelerin flebite ilişkin bilgi düzeylerinin, periferik intravenöz kateter değişim kararını vermedeki etkisini belirlemek amacıyla tanımlayıcı ve kesitsel olarak uygulanmıştır. Materyal ve Metot: Araştırma, İstanbul’da bir üniversite hastanesinde Ağustos-Ekim 2019 tarihleri arasında gerçekleştirilmiştir. Araştırmanın örneklemini, dahili ve cerrahi kliniklerde çalışan ve araştırmaya katılmaya gönüllü olan 56 hemşire ve bu kliniklerde yatarak tedavi gören ve izlem kriterlerine uyan, periferik intravenöz kateter takılı olan 151 hasta oluşturmuştur. Veriler; Demografik Bilgi Formu, Periferal İntravenöz Kateter ve Flebit Bilgi Formu ve Periferik İntravenöz Kateter Gözlem Formu ve Görsel İnfüzyon Flebit Skalası ile toplanmıştır. Çalışmanın ilk aşamasında; hemşirelerin demografik özellikleri ile periferal intravenöz kateter uygulamaları ve flebite ilişkin bilgi düzeyleri belirlenmiştir. İkinci aşamada araştırmaya dahil olan hemşirelerin bakım verdikleri hastaların izlemi yapılmıştır. Dahiliye ve cerrahi kliniklerinde yatarak tedavi gören ve çalışma kriterlerine uyan hastalar 4 gün boyunca günlük olarak flebit yönünden araştırmacı tarafından gözlenmiştir. Bulgular: Çalışmada, hemşirelerin %55.4’ünün bilgi düzeyi yeterli bulunmuştur. Bilgi düzeyi yeterli bulunan hemşirelerin %45.2’si, bilgi düzeyi yetersiz olan hemşirelerin 32.0’ı Görsel İnfüzyon Flebit Skala puanına göre uygun kateter değişimi yaptığı belirlenmiştir. Flebite ilişkin bilgi düzeyi yeterli olan hemşireler ile bilgi düzeyi yeterli olmayan hemşirelerin doğru zamanda kateter değişimi yapmaları arasında istatistiksel olarak anlamlı bir fark bulunmamıştır (p=0.467). Sonuç: Sonuç olaraki hemşirelerin flebite ilişkin bilgi düzeylerinin kateter değişim kararını vermede etkili olmadığı belirlenmiştir. Hastanelerde, periferal kateter uygulama ve bakım rehberlerinin kanıta dayalı uygulama önerilerine göre güncellenmesi önerilmiştir.

Keywords

• Kateterizasyon
• Periferal
• Flebit
• Hemşirelik

Investigation of the Effect of Nurses' Knowledge Level About Phlebitis on Peripheral Intravenous Catheter Replacement

Abstract

Objective: The study was applied descriptively and cross-sectionally to determine the effect of nurses' knowledge of phlebitis on the decision of peripheral intravenous catheter exchange. Material and Methods The research was carried out between August-October 2019 an university hospital in Istanbul. The sample of the study consisted of 56 nurses working in internal and surgical clinics and volunteering to participate in the study. A total of 151 patients who were hospitalized in these clinics and who met the follow-up criteria and who had a peripheral intravenous catheter inserted were included in the study. The data; Demographic Information Form was collected with Peripheral Intravenous Catheter and Phlebitis Information Form and Peripheral Intravenous Catheter Observation Form. In the first stage of the study; demographic characteristics of nurses and knowledge about peripheral intravenous catheter applications and phlebitis were determined. In the second stage, the patients who were cared for by the nurses included in the study were followed up. Patients who were hospitalized in internal medicine and surgical clinics and fulfilled the study criteria were observed by the researcher for phlebitis daily for 4 days. Results In this study, 55.4% of the nurses had sufficient knowledge level. While 32.0% of the nurses who had not sufficient knowledge level and 45.2% of the nurses who had sufficient knowledge level were found to have appropriate catheter change according to Visual Infusion Phlebitis Scale score. No statistically significant difference was found between the nurses who had sufficient knowledge of phlebitis and nurses whose knowledge level was not sufficient to perform catheter changes at the right time. (p = 0.467). Conclusion: As a result, it was determined that nurses' knowledge of phlebitis was not effective in making catheter change decision. In hospitals, it is recommended that PIC application and maintenance guidelines are updated according to evidence-based practice recommendations.

Keywords

• Nursing
• Peripheral Catheterization
• Phlebitis

References

1. 1. Keleekai, N, Schuster, C, Murray, C, King, M, Stahl, B, Labrozzi, L, Gallucci, S, et al., Improving nurses' peripheral intravenous catheter insertion knowledge confidence, and skills using a simulation-based blended learning program. Simulation in healthcare, 2016, 11, 376–384.
2. 2. Milutinović, D, Simin, D, Zec, D, Risk factor for phlebitis: a questionnaire study of nurses’ perception. Revista Latino-Americana de Enfermagem, 2015, 23(4), 677-684.
3. 3. Aydın, S, Arslan, GG, Hemşirelerin periferal intravenöz kateter girişimlerine ilişkin bilgi düzeylerinin incelenmesi, Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi, 2018, 11(4), 290-299.
4. 4. Ulusal Damar Erişimi Yönetimi Rehberi 2019. Hastane İnfeksiyonları Dergisi, 2019, 23(Ek 1), 1-54.
5. 5. Cicolini, G, Simonetti, V, Comparcini, D, Labeau, S, Blot, S, Pelusi, G, et al., Nurses’ knowledge of evidence-based guidelines on the prevention of peripheral venous catheter-related infections: a multicentre survey. Journal of Clinical Nursing, 2014, 23(17-18), 2578-2588.
6. 6. Kuş, B., Büyükyılmaz F, Periferik intravenöz kateter uygulamalarında komplikasyonların önlenmesinde güncel kanıtlar, Florence Nightingale Hemşirelik Dergisi, 2017, 25(3), 209-217
7. 7. Paşalıoğlu, KB, Kaya H, Catheter indwell time and phlebitis development during peripheral intravenous catheter administration, Pakistan Journal of MedicalSciences, 2014, 30(4), 725-730
8. 8. Urbanetto, JS, Peixoto, CG, May, TA, Incidence of phlebitis associated with the use of peripheral IV catheter and following catheter removal, Revista Latino-Americana de Enfermagem, 2016, 24, e2746.

9. 9. Centers for Disease Control and Prevention, Guidelines for the prevention of intravascular catheter related infections. http://www.cdc.gov/hicpac/pdf/guidelines/bsi‐guidelines‐2011.pdf (accessed 13.07.2020).
10. 10. Hossain, A, Arif, IA, Haque, M, Assessment of the level of knowledge and practice on intravenous cannulization among staff nurses of selected tertiary care hospital in Dhaka city, MedCrave Online Journal of Public Health, 2016, 4(5), 156-159.
11. 11. Castillo, MI, Larsen, E, Cooke, M, Mash, NM, Wallis, MC, Finucane, J, et al., Integrated versus non-integrated peripheral intravenous catheter. Which is the most effective system for peripheral intravenous catheter management? (The OPTIMUM study): a randomised controlled trial protocol, British Medical Journal Open, 2018, 8, e019916.
12. 12. Helm, R, Klausner, J, Klemperer, J, Flint, L, Huang, E, Accepted but unacceptable: Peripheral IV catheter failure, Infusion Nurses Society, 2015, 38, 3, 189-203.
13. 13. Vizcarra, C, Cassutt, C, Corbitt, N, Richardson, D, Runde, D, Stafford, K, Recommendations for improving safety practices with short peripheral catheters. Journal of Infusion Nursing, 2014, 37(2),121-124.
14. 14. Gorski, L, Hadaway, L, Hagle, M, McGoldrick, M, Orr, M, Doellman, D, Infusion therapy standards of practice, Journal of Infusion Nursing, 2016, 39,1S.
15. 15. Boyd, S, Aggarwal, I, Davey, P, Logan, M, Nathwani D, Peripheral intravenous catheters: the road to quality improvement and safer patient care, Journal of Hospital Infection, 2011, 77(1), 37-41.
16. 16. DeVries, M, Valentine, M, Mancos, P, Protected clinical indication of peripheral intravenous lines: Successful implementation, Journal of the Association for Vascular Access, 2016, 21(2), 89-92.
17. 17. Larsen, P, Eldridge, D, Brinkley, J, Newton, D, Goff, D, Hartzog, T, et al., Pediatric peripheral intravenous access: does nursing experience and competence really make a difference? Journal of Infusion Nursing, 2010, 33(4), 226-235.
18. 18. Ho, SE, Liew, LS, Tang, WM, Nurses’ knowledge and practice in relation to peripheral intravenous catheter care, Medicine and Health, 2016, 11(2), 181-188.
19. 19. Lyons, MG, Kasker, J, Outcomes of a continuing education course on ıntravenous catheter ınsertion for experienced registered nurses, The Journal of Continuing Education in Nursing, 2012, 43(4), 177-181.
20. 20. Osti, C, Khadka, M, Wosti, D, Gurung, G, Zhao, O, Knowledge and practice towards care and maintenance of peripheral intravenous cannula among nurses in Chitwan Medical College Teaching Hospital Nepal, Nursing Open, 2019, 6, 1006–1012.
21. 21. Qamar, Z, Azfal, M, Kousar, R, Waqas, A, Gilani, S, Assess nurses knowledge and practices towards care and maintenance of peripheral ıntravenous cannulation in Services Hospital Lahore, Pakistan, Saudi Journal of Medical and Pharmaceutical Sciences, 2017, 13, 608-614.
22. 22. Arbaee, IF, Ghazali, NMA. Nurses’ knowledge and practice towards care and maintenance of peripheral ıntravenous cannulation in Pantai Hospital, Batu Pahat, Johor, Malaysia, Published Thesis, Faculty of Nursing & Allied Health Sciences, Open University Malaysia, 2013, 22-26.