Santral Venöz Kateter Bakımında Kullanılan Standart Bakım ile Transparan Film Örtülerin Etkinliklerinin Karşılaştırılması: Olgu Kontrol Çalışması

Öz

Bu çalışma, santral venöz kateter (SVK) bakımında kullanılan standart bakım ile klorheksidin glukonat içeren transparan film örtülerin etkinliğinin kateter enfeksiyonu, bakım maliyeti, hemşire memnuniyeti ve verimliliği açısından karşılaştırılması amacıyla gerçekleştirildi. Çalışmanın evrenini, bir devlet hastanesinin Genel Yoğun Bakım Ünitesi'nde yatan hastalar ile bu ünitede çalışan hemşireler oluşturdu. Mart- Aralık 2020 tarihleri arasında olgu kontrol tipinde gerçekleştirilen çalışmada, kontrol grubuna standart SVK bakımı, olgu grubuna klorheksidin içeren transparan film örtüler ile SVK bakımı uygulandı. Veriler, hasta dosyalarından, hemşire gözlem formlarından, hemşireler ile birebir yüzyüze görüşerek ve enfeksiyon kontrol komitesinden sürveyans bilgileri alınarak araştırmacı tarafından toplandı. Verilerin analizi bir istatistik programından yardım alınarak yapıldı. Olgu grubunda SVK kullanım oranı 0,66 kontrol grubunda ise SVK kullanım oranı 0,55 olarak hesaplandı. Olgu grubunda SVK kullanım oranı kontrol grubuna göre fazla (p<0,05) olmasına karşın, santral venöz katater ile ilişkili kan dolaşımı enfeksiyonu gelişimi görülmedi. Olgu grubunda 77, kontrol grubunda ise 293 pansuman yapıldı. Kontrol grubunda rutin değişim, kirlilik, gevşeme nedeniyle olgu grubuna göre, olgu grubunda ise ıslaklık nedeniyle kontrol grubuna göre daha fazla pansuman gerçekleştiği görüldü. Buna rağmen, klorheksidin glukonat içeren şeffaf pansumanların maliyet etkinliği daha iyi bulundu. Bununla birlikte, klorheksidin glukonat içeren şeffaf pansumanların kullanılması hemşire memnuniyeti ve verimliliğini artırdığı görüldü. Şeffaf pansumanlar enfeksiyon açısından gazlı bezden önemli ölçüde farklı değildi. Klorheksidin glukonatlı şeffaf pansumanlar sınırlı maliyet etkinliği gösterirken, hemşire memnuniyeti ve verimliliğine olumlu katkıda bulundu.

Anahtar Kelimeler

• Santral Venöz Kateter
• Pansuman
• Kateter
• Enfeksiyon
• Yoğun Bakım
• Maliyet

Effectiveness of Transparent Dressing with Chlorhexidine Gluconate for Central Venous Catheter Care in the Intensive Care Unit: A Case Control Study

Öz

The objective of this study was to compare the efficacy of standard care and transparent film dressings containing chlorhexidine gluconate in the management of central venous catheters (CVCs) in terms of catheter-related infection, cost of care, nurse satisfaction and efficiency. The study population comprised patients hospitalised in the General Intensive Care Unit of the State Hospital, and nurses employed in this unit. In the case-control study conducted between March and December 2020, the control group received standard CVC care, while the case group received CVC care with transparent film covers containing chlorhexidine. The data were collected by the researcher from patient files, nurse observation forms, face-to-face interviews with nurses, and surveillance information from the infection control committee. The data were analysed using a statistical software program. The rate of CVC utilisation in the case group was 0.66, while the rate of CVC utilisation in the control group was 0.55. Despite the higher rate of CVC use observed in the case group compared to the control group (p < 0.05), there was no evidence of catheter-related bloodstream infection. A total of 77 dressings were performed in the case group, compared to 293 in the control group. It was observed that a greater number of dressings were performed in the control group than in the case group, due to the need for routine changes, the presence of contamination and loosening. Conversely, a greater number of dressings were performed in the case group than in the control group, due to the presence of wetness. However, the cost-effectiveness of transparent dressings containing chlorhexidine gluconate was found to be superior. Nevertheless, the utilisation of transparent dressings containing chlorhexidine gluconate appeared to enhance nurse satisfaction and efficiency. Transparent dressings demonstrated no significant distinction from gauze in terms of infection. While transparent dressings with chlorhexidine gluconate exhibited limited cost-effectiveness, they contributed favourably to nurse satisfaction and efficiency.

Anahtar Kelimeler

• Central Venous Catheter
• Dressings
• Catheter
• Infection
• Intensive Care
• Cost

Kaynakça

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