Barber Julie, Leslie Gavin
Julie Barber, RN, BN Clinical Nurse Consultant, Advanced Heart Failure and Cardiac Transplant Service, Royal Perth Hospital, and School of Nursing and Midwifery, Curtin University, Perth, Western Australia. Gavin Leslie, PhD, RN, BAppSC, Post Grad Dip (Clin Nurs), FCNA Professor Critical Care Nursing Head of Postgraduate Nursing Studies (joint appointment), School of Nursing and Midwifery, Curtin University, and Critical Care Division, Royal Perth Hospital, Perth, Western Australia.
J Cardiovasc Nurs. 2015 May-Jun;30(3):E1-E10. doi: 10.1097/JCN.0000000000000122.
Ventricular assist devices (VADs) have become an important therapy in the management of patients with end-stage heart failure. Driveline infection is the most common late-onset complication in this group of patients. Patients and their caregivers require education regarding management of the driveline to reduce the risk of infection when they are discharged home with a VAD.
The aim of this study was to develop an educational booklet on VAD driveline care for patients and their caregivers. A literature review was undertaken to explore the availability of patient education material pertaining to driveline management and to update evidence-informed knowledge that could potentially reduce infection rates in these patients. This information was evaluated by peers, patients, and caregivers to produce the final colored booklet.
Driveline care is not comprehensively discussed in the literature and lacks detail in the particulars of wound care, patient education, and the adaptation of driveline care to the patient's home environment. An educational booklet was designed to convey what is currently known about preventing driveline infections to those who are responsible for providing the required daily care. Evaluation of patient education material by those using the material is essential. As with all written material, the information will require updating as new evidence becomes available.
Managing driveline infection risk for patients at home with extended therapy is a critical nursing issue in improving morbidity and mortality. After VAD implantation, patients and caregivers must be educated about the ongoing care of the driveline exit site to minimize the risk of infection. A rigorously developed and patient-evaluated educational booklet on driveline exit site care can be a valuable reference tool for patients and caregivers after hospital discharge.
心室辅助装置（VAD）已成为终末期心力衰竭患者治疗的重要手段。导线感染是这类患者最常见的晚期并发症。患者及其护理人员需要接受有关导线管理的教育，以降低出院后在家使用VAD时发生感染的风险。
本研究的目的是为患者及其护理人员编写一本关于VAD导线护理的教育手册。进行了文献综述，以探索有关导线管理的患者教育材料的可用性，并更新可能降低这些患者感染率的循证知识。这些信息由同行、患者和护理人员进行评估，以制作最终的彩色手册。
文献中未全面讨论导线护理，在伤口护理细节、患者教育以及导线护理如何适应患者家庭环境方面缺乏详细内容。设计了一本教育手册，向负责提供日常护理的人员传达目前已知的预防导线感染的知识。由使用该材料的人员对患者教育材料进行评估至关重要。与所有书面材料一样，随着新证据的出现，信息需要更新。
在家中对接受长期治疗的患者管理导线感染风险是改善发病率和死亡率的关键护理问题。VAD植入后，必须对患者及其护理人员进行导线出口部位持续护理的教育，以尽量降低感染风险。一本经过严格编写并经患者评估的关于导线出口部位护理的教育手册，可成为患者和护理人员出院后的宝贵参考工具。
