Santral Venöz Kateterde Kanıta Dayalı Hemşirelik Bakım Yönetimi

Öz

Santral kateter ilişkili kan dolaşımı enfeksiyonu morbidite ve mortalitesi yüksek majör has-

tane enfeksiyonlarından biridir. Akut bakım hastanelerinde, özellikle yoğun bakım ünitelerinde

santral venöz kateterle ilgili tedavi ve bakım girişimlerinin geliştirilmesine gereksinim vardır. Bu

derleme, hemşirelerin ve diğer sağlık profesyonellerinin gereksinimi olan kanıta dayalı uygulamada

seçeneklerin sunulması ve güvenli, kaliteli ve maliyet etkili bakımın iyileştirilmesi amacıyla hazır-

lanmıştır. Derlemede santral kateter ilişkili kan dolaşımı enfeksiyonunu önlemeye yönelik, ulaşı-

labilen, görüş birliğine varılmış kanıta dayalı uygulama kılavuzları ve sistematik derlemeler

incelenmiştir. Santral venöz kateterle ilgili tanı, tedavi ve bakım amaçlı girişimleri içeren yakla-

şımlar verilmiştir. Bunlar; katetere erişimde genel ilkeler, kateterden kan örneği alma, kateterden

kan kültürü için kan örneği alma, kateter açıklığını sürdürme (kateteri yıkama, kateteri kilitleme,

kateter tıkanması), iğnesiz damar içi kateter sistemleri, infüzyon setlerini değiştirme ve kateter böl-

gesi pansumanından oluşmuştur. Ulusal koşullar ve klinik uygulamada gelen sorular göz önüne alı-

narak bazı özgün öneriler sunulmuştur. Derlemenin bakım uygulamalarının geliştirilmesine katkı

sağlayacağı öngörülmüştür.

Anahtar Kelimeler

• Kateterizasyon,santral venöz,kateter ilişkili enfeksiyon,kanıta dayalı hemşirelik,yoğun bakım

Evidenced-Based Nurcing Care Management at Central Venous Catheters

Abstract

Catheter related bloodstream infections are one of the high morbidity and mortality

of major hospital-acquired infections. Treatment and care interventions related to central venous

catheters are needed to be developed in acute care hospitals especially intensive care units. This

review was prepared with intent to present options in evidence-based practice needed by nurses and

other health professionals and to improve safe, quality and cost effective care. Evidence-based prac-

tice guidelines that are accessible and reached consensus for prevent catheter related bloodstream

infection and systematic reviews was examined in this review. Approaches including diagnostic,

treatment and maintenance purpose interventions related to central venous catheters were given.

These were composed of general principles in accessing catheter, taking blood samples from the

catheter, taking blood samples from the catheter for blood culture, maintaining patency of the

catheter (flushing the catheter, locking the catheter, occlusion of the catheter), needleless in-

travascular catheter systems, replacement of administration sets and catheter site dressing. Some

specific suggestions were presented considering national conditions and questions from clinical

practice. This review was expected to contribute to the development of the care implementations.

Keywords

• Catheterization,central venous,catheter-related infections,evidence based nursing,critical care

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