Jabaley Terri, Xiong Niya, Conley Susanne, Mazeika Teresa, Johnson Danielle, Biggins Brenda A, Hilton Nancy, Hong Fangxin
Clinical Inquiry Specialist, Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana Farber Cancer Institute, Boston, MA.
Statistician, Department of Data Science, Dana Farber Cancer Institute, Boston, MA.
Can Oncol Nurs J. 2022 Apr 1;32(2):286-293. doi: 10.5737/23688076322286293. eCollection 2022 Spring.
Central vascular access devices (CVADs) are often essential to the care of patients undergoing long-term cancer treatment. CVAD maintenance is an essential oncology nurse competency. Evidence-based practice (EBP) in flushing and locking help to prevent intraluminal occlusion, a common complication. Heparinized saline (HS) has been the standard locking solution for CVADs. However, research indicates no superiority of HS over normal saline (NS). The objectives of this EBP project were 1) to evaluate whether a significant difference in intraluminal occlusion was associated with the change from HS to NS use for locking CVADs in ambulatory oncology care, and 2) to evaluate the effects of peer nurse mentoring on nurses' and patients' perspectives about the practice change. Analysis of data revealed decreases in alteplase usage after transitioning to NS locking. Patient and nurse surveys indicated that peer nurse mentoring increased nurse and patient confidence and competence in making the practice transition.
中心血管通路装置（CVADs）对于接受长期癌症治疗的患者护理通常至关重要。CVAD维护是肿瘤专科护士的一项基本技能。冲洗和封管的循证实践（EBP）有助于预防管腔内堵塞这一常见并发症。肝素盐水（HS）一直是CVADs的标准封管溶液。然而，研究表明HS并不优于生理盐水（NS）。本EBP项目的目标是：1）评估在门诊肿瘤护理中，将CVADs封管溶液从HS改为NS使用后，管腔内堵塞是否存在显著差异；2）评估同伴护士指导对护士和患者关于实践改变的看法的影响。数据分析显示，转为使用NS封管后阿替普酶的使用量减少。患者和护士调查表明，同伴护士指导增强了护士和患者对实践转变的信心和能力。
