Rickard Claire M, Courtney Mary, Webster Joan
School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.
J Adv Nurs. 2004 Nov;48(3):247-56. doi: 10.1111/j.1365-2648.2004.03193.x.
This paper describes the current infection control practices for CVC care and compares these to evidence-based practice guidelines.
Intensive care patients with central venous catheters (CVCs) are at risk of catheter-related infection, which increases morbidity, mortality and health care costs. Infection control practices, including care of intravenous administration sets and catheter sites, are undertaken by nurses in an attempt to avoid infection. Although practice guidelines are available, infection control practices may vary between practitioners and institutions; however, current practice has not been formally surveyed.
A prospective, cross-sectional descriptive survey was carried out. Intensive care units (n = 14) in Australia were surveyed about their infection control policies for CVC care. Results were tabulated and compared with evidence-based practice guidelines.
A wide variety of responses was received about duration of administration set use for standard, parenteral nutrition and propofol (lipid-based anaesthetic) infusions; ad hoc administration set connection technique; dressing frequency, materials and solutions; and barrier precautions used during procedures. There was inconsistent adherence to the guidelines.
There is variation in the infection control approach to CVC care. Greater adherence to existing Centers for Disease Control Guidelines would assist in the standardization of best practice and facilitate evidence-based care.
本文描述了当前中心静脉导管(CVC)护理的感染控制措施,并将其与循证实践指南进行比较。
重症监护病房中使用中心静脉导管(CVC)的患者存在导管相关感染的风险,这会增加发病率、死亡率和医疗费用。护士采取感染控制措施,包括静脉输液装置和导管部位的护理,以避免感染。尽管有实践指南,但不同从业者和机构的感染控制措施可能存在差异;然而,目前尚未对当前实践进行正式调查。
开展了一项前瞻性横断面描述性调查。对澳大利亚的14个重症监护病房就其CVC护理的感染控制政策进行了调查。将结果制成表格,并与循证实践指南进行比较。
对于标准输液、肠外营养和丙泊酚(脂质类麻醉剂)输注的输液装置使用时长、临时输液装置连接技术、换药频率、材料和溶液,以及操作过程中使用的屏障预防措施,收到了各种各样的回复。对指南的遵守情况不一致。
CVC护理的感染控制方法存在差异。更好地遵守现有的疾病控制中心指南将有助于最佳实践的标准化,并促进循证护理。