Nursing İntervention to Prevent Infection and Thrombosis Associated with Central Venous Catheter in Children

Öz

Central venous catheter is usually placed in children in cases where peripheral venous access cannot be achieved or is inadequate in treatment by using a peripheral catheter. Central venous catheter is preferred in patients requiring long-term chemotherapy, parenteral nutrition, blood transfusion as well as intensive and recurrent intravenous intervention. Central venous catheter use is common in pediatric intensive care and hematology/oncology clinics. Central venous catheter allows to shorten the hospitalization process of the child, reduce costs and reduce the frequency of painful invasive procedures. Evidence-based interventions in clinics may lead to life-threatening complications if central venous catheter is not maintained in appropriate conditions. The most common complications are infection and thrombosis. Complications may lead to delay in the treatment process in children and early withdrawal of central venous catheter. In order to prevent central venous catheter complications, the dressing of the catheter region and the washing of the lumen are routinely performed by nurses in the clinic. However, central venous catheter complication rates are still high today. Nurses should be aware of the current evidence-based guidelines about the interventions they implement, and updating their knowledge for reducing the complications. More randomized controlled experimental studies are needed in this population.

Anahtar Kelimeler

• Children
• central venous catheter
• infection
• nursing
• thrombosis

Çocuklarda Santral Venöz Kateterle İlişkili Enfeksiyon ve Trombozu Önlemeye Yönelik Hemşirelik Girişimleri

Öz

Santral venöz kateter, genellikle çocuklarda periferik kateter kullanılarak venöz erişim sağlanamadığı ya da tedavide yetersiz kaldığı durumlarda yerleştirilmektedir. Uzun süreli kemoterapi tedavisi, parenteral beslenme, kan transfüzyonu ve infüzyon gibi yoğun ve tekrarlı intravenöz girişim gereken hastalarda santral venöz kateter tercih edilmektedir. Çocuk yoğun bakım ve hematoloji/onkoloji kliniklerinde santral venöz kateter kullanımı yaygındır. Santral venöz kateter, çocuğun hastaneye yatış sürecini kısaltmaya, maliyetleri düşürmeye ve ağrılı invaziv girişim sıklığını azaltmaya olanak sağlar. Kliniklerde kanıta dayalı girişimlerle santral venöz kateter bakımı yapılmadığında çocuklarda hayatı tehdit eden komplikasyonlar gelişebilmektedir. En sık görülen komplikasyonlar enfeksiyon ve trombozdur. Komplikasyonlar çocuklarda tedavi sürecinde gecikmeye ve Santral venöz kateterin erken çıkarılmasına yol açabilmektedir. Santral venöz kateter komplikasyonlarını önlemek amacıyla kateter bölgesinin pansumanı ve lümeninin yıkanması hemşirelerin klinikte rutinde uyguladığı girişimlerdir. Ancak, santral venöz kateter komplikasyon oranlarının günümüzde hala yüksek olduğu görülmektedir. Hemşireler Santral venöz katetere bağlı gelişen tüm komplikasyonları önlemek, erken dönemde belirlemek ve tedavi etmek için gerekli çalışmaları koordine ve takip etmekten sorumludur. Hemşirelerin uyguladıkları girişimlerle ilgili güncel kanıta dayalı rehberlerden haberdar olmaları ve bilgilerini güncellemeleri gerekir. Bu derlemede, santral venöz kateteri olan çocuklarda komplikasyonları önlemeye yönelik mevcut kanıtların yetersiz olduğu görülmüştür. Bu nedenle, bu popülasyonda daha fazla sayıda randomize kontrollü deneysel çalışma yapılmasına ihtiyaç vardır.

Anahtar Kelimeler

• Çocuk
• enfeksiyon
• hemşirelik
• santral venöz kateter
• tromboz

Kaynakça

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