Hoekstra Bettie P, de Vries-Hoogsteen Anneke, Winkels Bieneke, Zevenbergen-Osinga Helma, Thijssen-Broers Ingrid, Bellemakers Trian
Maasstad Hospital, Rotterdam, The Netherlands.
Care group Noorderbreedte, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
J Ren Care. 2017 Sep;43(3):156-162. doi: 10.1111/jorc.12199. Epub 2017 Apr 6.
The aim of this paper is to describe the quality of exit site care by evaluating the use of the Dutch exit site guideline over a period of 15 years.
The special interest group (SIG) for peritoneal dialysis (PD) analysed results of three surveys concerning general exit site care among members of the Dutch Association for nurses and carers (V&VN), the dialysis and nephrology section.
In 2002 (when no guidelines were available) the survey showed huge diversity in practice, with no definition of the post-operative period after catheter placement and no uniform monitoring of the exit site. There was a difference in use of dressings and exit site care. In 2009, the survey showed that most dialysis centres worked with the first guideline of the V&VN (2006) and exit site classification (2006). However, at this time, there was still diversity in the way exit site care was undertaken. In 2016, there was widespread use of guidelines and classification alongside a more individual approach to practice. Differences occured in use of disinfectant, antimicrobial ointment, swimming and going to the sauna.
The exit site guideline has been widely used in the Netherlands, improving quality in care and utilising a more individual patient approach in care. However, there are still differences identified in practice for which the evidence-base and evaluation will be undertaken to supplement the guideline and attribute to exit site care practice.
本文旨在通过评估荷兰出口部位护理指南在15年期间的使用情况来描述出口部位护理的质量。
腹膜透析（PD）特别兴趣小组（SIG）分析了荷兰护士与护理人员协会（V&VN）透析与肾脏病科成员进行的三项关于一般出口部位护理的调查结果。
2002年（当时尚无指南）的调查显示实践中存在巨大差异，导管置入术后的时间段没有定义，出口部位也没有统一的监测。敷料使用和出口部位护理存在差异。2009年的调查显示，大多数透析中心采用了V&VN的第一版指南（2006年）和出口部位分类（2006年）。然而，此时出口部位护理的实施方式仍存在差异。2016年，指南和分类得到广泛应用，同时实践中采用了更个性化的方法。在消毒剂、抗菌软膏的使用、游泳和去桑拿方面存在差异。
出口部位护理指南在荷兰已得到广泛应用，提高了护理质量，并在护理中采用了更个性化的患者护理方法。然而，实践中仍存在差异，将对其进行循证和评估，以补充指南并为出口部位护理实践提供依据。
