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Yıl 2021, , 298 - 306, 27.10.2021
https://doi.org/10.5472/marumj.1012090

Öz

Kaynakça

  • [1] Kurt B. Evidence-based nursing practices to prevent central venous catheter infections. Journal of Adnan Menderes University Health Sciences Faculty 2018;2:21-7.
  • [2] Hakyemez IN, Yildirmak MT, Cetmeli G, Iris NE. Prevalence, causative microorganisms, and risk factors of central venous catheter-related infections in a tertiary care hospital. Abant Med J 2016;5:108-17.
  • [3] Wright MO, Decker SG, Allen-Bridson K, Hebden JN, Leaptrot D. Healthcare–associated infections studies project: An American Journal of Infection Control and National Healtcare Safety Network data quality collaboration: Location mapping. Am J Infect Control 2018;46:577-8. https://doi. org/10.1016/j.ajic.2017.12.012.
  • [4] Karasu D, Yilmaz C, Durmus G, Ozer D, Caglayan U, Karaduman I, Asan A. Evaluation of healthcare-associated infections in critically ill patients receiving long-term treatment in the intensive care unit. Klimik Journal 2016; 29:71-6. doi:10.5152/kd.2016.17
  • [5] Zabidi HAZ, Ali GM, Naqshbandi E. The effect of nurses’ implementation of central vascular catheter maintenance care bundle on bloodstream infection among ICU patients in KFGH and KAAUH. International Journal of Nursing Didactics 2018; 7:10-6. doi: 10.15520/ijnd.v7i12.2153
  • [6] Sanli D, Sarikaya A. Evidenced-based nursing care management at central venous catheters. Journal of the Turkish Society of Critical Care Nurses 2016;20:84-97.
  • [7] Alkubati SA, Ahmed NT, Mohamed ONE, Fayed AM, Asfour HI. Health care workers’ knowledge and practices regarding the prevention of central venous catheter-related infection. Am J Infect Control 2015;43:26-30. doi:10.1016/j.ajic.2014.09.021
  • [8] Bati B, Ozyurek P. Knowledge levels of intensive care unit nurses on central venous catheters. Journal of Medical and Surgical Intensive Care 2015;6:34-8. doi: 10.5152/ dcbybd.2015.828
  • [9] Gnanarani J, Venkatesan L, Manikandan. Effectiveness of central line bundle care upon the knowledge and compliance staff nurses in the ICU. International Journal of Advance Research, Ideas and Innovations in Technology 2018;4:2059-63. https://www.ijariit.com/manuscripts/v4i3/ V4I3-1793.pdf Accessed: June 25, 2019
  • [10] Manzo BF, Mariano DR, Ferreira FMC, et al. Knowledge and behavior of professionals about bundled strategies of central venous catheter. Rev Bras Enferm 2019;72:50-6. doi: 10.1590/0034-7167-2018-0164.
  • [11] Mutlu EY, Senturan L. Effects of hickman catheter care training on practices of nurses. International Journal of Caring Sciences 2017; 10 :16-33.
  • [12] Ozen N, Kose T, Terzioglu F. Evidence-based practices in the prevention of central venous catheter infections: Knowledge of intensive care nurses. Turk J Intensive Care 2020;18:91-8. doi: 10.4274/tybd.galenos.2019.25991
  • [13] Sharour A. Oncology nurses’ knowledge about central line catheter: caring, complications, and applications among cancer patients – a cross-sectional study. J Vasc Nurs 2018;36:145-8. doi:10.1016/j.jvn.2018.04.002.
  • [14] Gillespie BM, Polit DF, Hamlin L, Chaboyer W. Developing a model of competence in the OR: Psychometric validation of perceived perioperative competence scale-revised. Int J Nurs Stud 2012;49:90-101. doi:10.1016/j.ijnurstu.2011.08.001.
  • [15] Infection prevention and control of healthcare-associated infections in primary and community care. National Institute for Health and Care Excellence 2012. https://www.nice.org.uk/ guidance/cg139/resources/healthcareassociated-infectionsprevention- and-control-in-primary-and-community-carepdf- 351.095.18767045 Accessed:July 11, 2019
  • [16] Arslan GG, Ozden D, Alan N, Yilmaz I, Ayik C, Goktuna G. Examination of nursing drug administration practices via central venous catheter: An observational study. J Vasc Access 2020;21:426-33. doi: 10.1177/112.972.9819880979.
  • [17] Devi R, Ghai S, Singh NV, Puri GD. A methodological study to develop a standard operational protocol for nurses on central line catheter care of patients in selected intensive care units. Indian J Crit Care Med 2017;21:483-7. doi: 10.4103/ijccm. IJCCM_261_16.
  • [18] Gerceker G, Yardimci F, Aydinok Y. Randomized controlled trial of care bundles with chlorhexidine dressing and advanced dressing to prevent catheter related bloodstream infections in pediatric hematology-oncology patients. Eur J Oncol Nurs 2017;28:14-20. doi:10.1016/j.ejon.2017.02.008.
  • [19] Marschall J, Mermel LA, Fakih M, et al. Strategies to prevent central line-associated bloodstream infections in acute care hospitals. Infect Control Hosp Epidemiol 2014;35:753-71. doi:10.1086/676533.
  • [20] Global Infection Prevention and Control Unit. Evidence of hand hygiene as the building block for infection prevention and control. World Health Organization 2017. https:// creativecommons.org/licenses/by-nc-sa/ 3.0/igo. Accessed: August 4, 2019
  • [21] Caner N, Tekinsoy KP. The assessment of the intramuscular and intravenous drug administration steps of nurses: Observation study. HUHEMFAD-JOHUFON 2019;6:177-85. doi: 10.31125/hunhemsire.630812.
  • [22] Kazan EE, Gorgulu S. Skills of the nurses about the administration of subcutaneous low molecular weight heparin injection. HUHEMFAD-JOHUFON 2009:1-13.
  • [23] Acun A, Caliskan N. Evaluation of effectiveness of central venous catheter related bloodstream infections in the antesty and reanimation intensive care units of the bundle. Ann Med Res 2021;28:792-8. doi: 10.5455/annalsmedres.2020.06.587.
  • [24] Berman A, Snyder SJ. Kozier& Erb’s fundamentals of nursing, concepts, process and practice. 10th ed. Pearson, 2015: 814-27.
  • [25] Iseri A, Cinar B, Duzkaya DS, , et al. National vessel access management guide. Turkish Journal of Hospital Infections 2019;23:1-54. http://www.hider.org.tr/global/Dernek_ Kilavuzlari/HID_Damar%20Erisimi%20Rehberi_2019.pdf . Accessed: August 16, 2019
  • [26] Lynn P B. Taylor’s clinical nursing skills. A nursing process approach. 5th ed. Philadelphia, PA:Wolters Kluwer, 2018: 813- 21.
  • [27] O’Grady NP, Alexander M, Burns LA, et al. Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis 2011;52:162-93. doi:10.1093/cid/cir257.
  • [28] Sardan YC, Guner R, Cakar N, et al. Guidelines for the prevention of intravenous catheter infections. Turkish Journal of Hospital Infections 2013;17:233-78.http://www. hider.org.tr/global/Dernek_Kilavuzlari/Damar_ici_Kateter_ infeksiyonlarinin_Onlenmesi_Kilavuzu.pdf. Accessed: July 25, 2019
  • [29] Esposito MR, Guillari A, Angelillo IT. Knowledge, attitudes, and practice on the prevention of central line-associated bloodstream infections among nurses in oncological care: A cross-sectional study in an area of Southern Italy. PloS One 2017;12:1-11. doi:10.1371/journal.pone. 0180473.
  • [30] Aydogdu S, Akgun M. Determination of knowledge levels of nurses and the factors affecting the level of knowledge in central venous catheter care. Clinical Nursing Studies 2020;8:1-9. https://doi.org/10.5430/cns.v8n2p1.
  • [31] Preventing central line–associated bloodstream infections: A global challenge, a global perspective. The Joint Commission 2012. https://www.jointcommission.org/-/ media/deprecated-unorganized/imported-assets/tjc/ system-folders/topics-library/clabsi_monographpdf. pdf?db=web&hash=86103821F3C7FF8A7683C933EA0CB391 Accessed: March 7, 2019
  • [32] Abdo NM, Fadhli MA. Improving hand hygiene compliance among healthcare workers in intensive care unit: an interventional study. Int J Community Med Public Health 2018;5:3747-52.http://dx.doi.org/10.18203/2394-6040. ijcmph20183558.
  • [33] Yurttas A, Kaya A, Engin R. Examination of hospital infection and hand hygiene compliance in intensive care unit of a university hospital. Arch Health Sci Res 2017;4 :1-7. doi:10.17681/hsp.115490.
  • [34] Snarski E, Mank A, Iacobelli S, et al. Current practices used for the prevention of central venous catheter-associated infection in hematopoietic stem cell transplantation recipients: A survey from the infectious diseases working party and nurses’ group of EBMT. Transpl Infect Dis 2015;17:558-65. https:// doi.org/10.1111/tid.12399.
  • [35] Lai NM, Lai AN, O’Riordan E, et al. Skin antisepsis for reducing central venous catheter-related infections. Cochrane Database of Syst Rev 2016;7: CD010140. doi: 10.1002/14651858. CD010140.pub2.
  • [36] Central venous catheter hub cleaning prior to accessing. Centers for Disease Control and Prevention 2011. https:// www.cdc.gov/dialysis/PDFs/collaborative/Protocol-Hub- Cleaning-FINAL-3-12.pdf. Accessed: August 20, 2019
  • [37] Preventing central line–associated bloodstream infections: Useful tools, an international perspective, scrub the hub. The Joint Commission 2013. https://www.jointcommission.org/-/ media/tjc/documents/resources/health-services-research/ clabsi-toolkit/clabsi_toolkit_tool_3-21_scrub_the_hubpdf. pdf?db=web&hash=79BF0D29BD4AAF13DEC3C3DE5AB90494. Accessed: August 20, 2019
  • [38] Wright MO, Tropp J, Schora DM, Grant MD, Peterson K. Continuous passive disinfection of catheter hubs prevents contamination and bloodstream infection. Am J Infect Control 2013;41:33-8. doi:10.1016/j.ajic.2012.05.030.
  • [39] Desra AP, Breen J, Harper S, Slavin MA, Worth LJ. Aseptic technique for accessing central venous catheters: Applying a standardized tool to audit ‘scrub the hub’ practices. J Vasc Access 2016;17:269-72. doi:10.5301/jva.5000509.
  • [40] Hosaf S. Investigation of the effectiveness of continuous education given with internet-mediated communication to nurses on central venous catheter care management (thesis). Izmir: Ege Univ; 2019.

Evaluation of skills of intensive care nurses regarding central venous catheter care: An observational study

Yıl 2021, , 298 - 306, 27.10.2021
https://doi.org/10.5472/marumj.1012090

Öz

Objective: Central venous access is a common procedure performed in many clinical settings for a variety of indications. Yet, there
are multiple complications related to central venous catheter use. Significant morbidity and mortality can result from complications
related to central venous catheters. Therefore, safety and effectiveness of central venous catheter care by nurses is crucial. The aim of
this study was to evaluate the intensive care nursing skills associated with central venous catheter care.
Materials and Methods: This observational study was conducted with 37 volunteer nurses who were employed in adult intensive care
units of three hospitals in Istanbul, Turkey. A total of 111 observations were collected by using the Nurses’ Descriptive Characteristics
Form and the Intensive Care Nurses’ Central Venous Catheter Care Skills Observation Checklist.
Results: The average age of the nurses was 33.2 ± 5.9 years. The study showed that 93.7% nurses had performed the hand hygiene
before starting the central venous catheter care but seldom after the procedure. Sterile gloves were not used by majority of the nurses
during the care. They almost never disinfected the catheter hub, and they did not adequately obey the rules after completing the care
procedure.
Conclusions: This study demonstrated that nurses had inadequate skills of central venous catheter care. We recommend that nurses’
skills must be enriched with professional theoretical and practical trainings.

Kaynakça

  • [1] Kurt B. Evidence-based nursing practices to prevent central venous catheter infections. Journal of Adnan Menderes University Health Sciences Faculty 2018;2:21-7.
  • [2] Hakyemez IN, Yildirmak MT, Cetmeli G, Iris NE. Prevalence, causative microorganisms, and risk factors of central venous catheter-related infections in a tertiary care hospital. Abant Med J 2016;5:108-17.
  • [3] Wright MO, Decker SG, Allen-Bridson K, Hebden JN, Leaptrot D. Healthcare–associated infections studies project: An American Journal of Infection Control and National Healtcare Safety Network data quality collaboration: Location mapping. Am J Infect Control 2018;46:577-8. https://doi. org/10.1016/j.ajic.2017.12.012.
  • [4] Karasu D, Yilmaz C, Durmus G, Ozer D, Caglayan U, Karaduman I, Asan A. Evaluation of healthcare-associated infections in critically ill patients receiving long-term treatment in the intensive care unit. Klimik Journal 2016; 29:71-6. doi:10.5152/kd.2016.17
  • [5] Zabidi HAZ, Ali GM, Naqshbandi E. The effect of nurses’ implementation of central vascular catheter maintenance care bundle on bloodstream infection among ICU patients in KFGH and KAAUH. International Journal of Nursing Didactics 2018; 7:10-6. doi: 10.15520/ijnd.v7i12.2153
  • [6] Sanli D, Sarikaya A. Evidenced-based nursing care management at central venous catheters. Journal of the Turkish Society of Critical Care Nurses 2016;20:84-97.
  • [7] Alkubati SA, Ahmed NT, Mohamed ONE, Fayed AM, Asfour HI. Health care workers’ knowledge and practices regarding the prevention of central venous catheter-related infection. Am J Infect Control 2015;43:26-30. doi:10.1016/j.ajic.2014.09.021
  • [8] Bati B, Ozyurek P. Knowledge levels of intensive care unit nurses on central venous catheters. Journal of Medical and Surgical Intensive Care 2015;6:34-8. doi: 10.5152/ dcbybd.2015.828
  • [9] Gnanarani J, Venkatesan L, Manikandan. Effectiveness of central line bundle care upon the knowledge and compliance staff nurses in the ICU. International Journal of Advance Research, Ideas and Innovations in Technology 2018;4:2059-63. https://www.ijariit.com/manuscripts/v4i3/ V4I3-1793.pdf Accessed: June 25, 2019
  • [10] Manzo BF, Mariano DR, Ferreira FMC, et al. Knowledge and behavior of professionals about bundled strategies of central venous catheter. Rev Bras Enferm 2019;72:50-6. doi: 10.1590/0034-7167-2018-0164.
  • [11] Mutlu EY, Senturan L. Effects of hickman catheter care training on practices of nurses. International Journal of Caring Sciences 2017; 10 :16-33.
  • [12] Ozen N, Kose T, Terzioglu F. Evidence-based practices in the prevention of central venous catheter infections: Knowledge of intensive care nurses. Turk J Intensive Care 2020;18:91-8. doi: 10.4274/tybd.galenos.2019.25991
  • [13] Sharour A. Oncology nurses’ knowledge about central line catheter: caring, complications, and applications among cancer patients – a cross-sectional study. J Vasc Nurs 2018;36:145-8. doi:10.1016/j.jvn.2018.04.002.
  • [14] Gillespie BM, Polit DF, Hamlin L, Chaboyer W. Developing a model of competence in the OR: Psychometric validation of perceived perioperative competence scale-revised. Int J Nurs Stud 2012;49:90-101. doi:10.1016/j.ijnurstu.2011.08.001.
  • [15] Infection prevention and control of healthcare-associated infections in primary and community care. National Institute for Health and Care Excellence 2012. https://www.nice.org.uk/ guidance/cg139/resources/healthcareassociated-infectionsprevention- and-control-in-primary-and-community-carepdf- 351.095.18767045 Accessed:July 11, 2019
  • [16] Arslan GG, Ozden D, Alan N, Yilmaz I, Ayik C, Goktuna G. Examination of nursing drug administration practices via central venous catheter: An observational study. J Vasc Access 2020;21:426-33. doi: 10.1177/112.972.9819880979.
  • [17] Devi R, Ghai S, Singh NV, Puri GD. A methodological study to develop a standard operational protocol for nurses on central line catheter care of patients in selected intensive care units. Indian J Crit Care Med 2017;21:483-7. doi: 10.4103/ijccm. IJCCM_261_16.
  • [18] Gerceker G, Yardimci F, Aydinok Y. Randomized controlled trial of care bundles with chlorhexidine dressing and advanced dressing to prevent catheter related bloodstream infections in pediatric hematology-oncology patients. Eur J Oncol Nurs 2017;28:14-20. doi:10.1016/j.ejon.2017.02.008.
  • [19] Marschall J, Mermel LA, Fakih M, et al. Strategies to prevent central line-associated bloodstream infections in acute care hospitals. Infect Control Hosp Epidemiol 2014;35:753-71. doi:10.1086/676533.
  • [20] Global Infection Prevention and Control Unit. Evidence of hand hygiene as the building block for infection prevention and control. World Health Organization 2017. https:// creativecommons.org/licenses/by-nc-sa/ 3.0/igo. Accessed: August 4, 2019
  • [21] Caner N, Tekinsoy KP. The assessment of the intramuscular and intravenous drug administration steps of nurses: Observation study. HUHEMFAD-JOHUFON 2019;6:177-85. doi: 10.31125/hunhemsire.630812.
  • [22] Kazan EE, Gorgulu S. Skills of the nurses about the administration of subcutaneous low molecular weight heparin injection. HUHEMFAD-JOHUFON 2009:1-13.
  • [23] Acun A, Caliskan N. Evaluation of effectiveness of central venous catheter related bloodstream infections in the antesty and reanimation intensive care units of the bundle. Ann Med Res 2021;28:792-8. doi: 10.5455/annalsmedres.2020.06.587.
  • [24] Berman A, Snyder SJ. Kozier& Erb’s fundamentals of nursing, concepts, process and practice. 10th ed. Pearson, 2015: 814-27.
  • [25] Iseri A, Cinar B, Duzkaya DS, , et al. National vessel access management guide. Turkish Journal of Hospital Infections 2019;23:1-54. http://www.hider.org.tr/global/Dernek_ Kilavuzlari/HID_Damar%20Erisimi%20Rehberi_2019.pdf . Accessed: August 16, 2019
  • [26] Lynn P B. Taylor’s clinical nursing skills. A nursing process approach. 5th ed. Philadelphia, PA:Wolters Kluwer, 2018: 813- 21.
  • [27] O’Grady NP, Alexander M, Burns LA, et al. Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis 2011;52:162-93. doi:10.1093/cid/cir257.
  • [28] Sardan YC, Guner R, Cakar N, et al. Guidelines for the prevention of intravenous catheter infections. Turkish Journal of Hospital Infections 2013;17:233-78.http://www. hider.org.tr/global/Dernek_Kilavuzlari/Damar_ici_Kateter_ infeksiyonlarinin_Onlenmesi_Kilavuzu.pdf. Accessed: July 25, 2019
  • [29] Esposito MR, Guillari A, Angelillo IT. Knowledge, attitudes, and practice on the prevention of central line-associated bloodstream infections among nurses in oncological care: A cross-sectional study in an area of Southern Italy. PloS One 2017;12:1-11. doi:10.1371/journal.pone. 0180473.
  • [30] Aydogdu S, Akgun M. Determination of knowledge levels of nurses and the factors affecting the level of knowledge in central venous catheter care. Clinical Nursing Studies 2020;8:1-9. https://doi.org/10.5430/cns.v8n2p1.
  • [31] Preventing central line–associated bloodstream infections: A global challenge, a global perspective. The Joint Commission 2012. https://www.jointcommission.org/-/ media/deprecated-unorganized/imported-assets/tjc/ system-folders/topics-library/clabsi_monographpdf. pdf?db=web&hash=86103821F3C7FF8A7683C933EA0CB391 Accessed: March 7, 2019
  • [32] Abdo NM, Fadhli MA. Improving hand hygiene compliance among healthcare workers in intensive care unit: an interventional study. Int J Community Med Public Health 2018;5:3747-52.http://dx.doi.org/10.18203/2394-6040. ijcmph20183558.
  • [33] Yurttas A, Kaya A, Engin R. Examination of hospital infection and hand hygiene compliance in intensive care unit of a university hospital. Arch Health Sci Res 2017;4 :1-7. doi:10.17681/hsp.115490.
  • [34] Snarski E, Mank A, Iacobelli S, et al. Current practices used for the prevention of central venous catheter-associated infection in hematopoietic stem cell transplantation recipients: A survey from the infectious diseases working party and nurses’ group of EBMT. Transpl Infect Dis 2015;17:558-65. https:// doi.org/10.1111/tid.12399.
  • [35] Lai NM, Lai AN, O’Riordan E, et al. Skin antisepsis for reducing central venous catheter-related infections. Cochrane Database of Syst Rev 2016;7: CD010140. doi: 10.1002/14651858. CD010140.pub2.
  • [36] Central venous catheter hub cleaning prior to accessing. Centers for Disease Control and Prevention 2011. https:// www.cdc.gov/dialysis/PDFs/collaborative/Protocol-Hub- Cleaning-FINAL-3-12.pdf. Accessed: August 20, 2019
  • [37] Preventing central line–associated bloodstream infections: Useful tools, an international perspective, scrub the hub. The Joint Commission 2013. https://www.jointcommission.org/-/ media/tjc/documents/resources/health-services-research/ clabsi-toolkit/clabsi_toolkit_tool_3-21_scrub_the_hubpdf. pdf?db=web&hash=79BF0D29BD4AAF13DEC3C3DE5AB90494. Accessed: August 20, 2019
  • [38] Wright MO, Tropp J, Schora DM, Grant MD, Peterson K. Continuous passive disinfection of catheter hubs prevents contamination and bloodstream infection. Am J Infect Control 2013;41:33-8. doi:10.1016/j.ajic.2012.05.030.
  • [39] Desra AP, Breen J, Harper S, Slavin MA, Worth LJ. Aseptic technique for accessing central venous catheters: Applying a standardized tool to audit ‘scrub the hub’ practices. J Vasc Access 2016;17:269-72. doi:10.5301/jva.5000509.
  • [40] Hosaf S. Investigation of the effectiveness of continuous education given with internet-mediated communication to nurses on central venous catheter care management (thesis). Izmir: Ege Univ; 2019.
Toplam 40 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Original Articles
Yazarlar

Gulnur Kar Bu kişi benim

Ebru Erek Kazan Bu kişi benim

Yayımlanma Tarihi 27 Ekim 2021
Yayımlandığı Sayı Yıl 2021

Kaynak Göster

APA Kar, G., & Erek Kazan, E. (2021). Evaluation of skills of intensive care nurses regarding central venous catheter care: An observational study. Marmara Medical Journal, 34(3), 298-306. https://doi.org/10.5472/marumj.1012090
AMA Kar G, Erek Kazan E. Evaluation of skills of intensive care nurses regarding central venous catheter care: An observational study. Marmara Med J. Ekim 2021;34(3):298-306. doi:10.5472/marumj.1012090
Chicago Kar, Gulnur, ve Ebru Erek Kazan. “Evaluation of Skills of Intensive Care Nurses Regarding Central Venous Catheter Care: An Observational Study”. Marmara Medical Journal 34, sy. 3 (Ekim 2021): 298-306. https://doi.org/10.5472/marumj.1012090.
EndNote Kar G, Erek Kazan E (01 Ekim 2021) Evaluation of skills of intensive care nurses regarding central venous catheter care: An observational study. Marmara Medical Journal 34 3 298–306.
IEEE G. Kar ve E. Erek Kazan, “Evaluation of skills of intensive care nurses regarding central venous catheter care: An observational study”, Marmara Med J, c. 34, sy. 3, ss. 298–306, 2021, doi: 10.5472/marumj.1012090.
ISNAD Kar, Gulnur - Erek Kazan, Ebru. “Evaluation of Skills of Intensive Care Nurses Regarding Central Venous Catheter Care: An Observational Study”. Marmara Medical Journal 34/3 (Ekim 2021), 298-306. https://doi.org/10.5472/marumj.1012090.
JAMA Kar G, Erek Kazan E. Evaluation of skills of intensive care nurses regarding central venous catheter care: An observational study. Marmara Med J. 2021;34:298–306.
MLA Kar, Gulnur ve Ebru Erek Kazan. “Evaluation of Skills of Intensive Care Nurses Regarding Central Venous Catheter Care: An Observational Study”. Marmara Medical Journal, c. 34, sy. 3, 2021, ss. 298-06, doi:10.5472/marumj.1012090.
Vancouver Kar G, Erek Kazan E. Evaluation of skills of intensive care nurses regarding central venous catheter care: An observational study. Marmara Med J. 2021;34(3):298-306.