Autori: Synnove Hvidevold Moe
Ustanova zaposlenja: Norway
Ključne riječi: CVC, CRBSI, Infections, procedures, evidence based
Kongres/Simpozij: ”5. Međunarodni kongres HDMSARIST-a” i ”8. Međunarodni kongres WFCCN-a”
Mjesto i vrijeme održavanja: Šibenik, 12.-15. travnja 2012. godine
CVC
(Central venous catheters) – Care and maintenance of tunneled and non-tunneled
catheters in adult patients.
Background: CVC play an important role in the treatment of critically ill
patients. Unfortunately complications such as intravascular catheter related
bloodstream infections (CRBSI) often occur. Infections are a major problem in
hospitals all over the world, and CRBSI is a serious complication with high
mortality rate. There was a need in our hospital to create a new and
standardized procedure based on the evidence based knowledge related to
prevention of CRBSI in patients with CVC`s.
Aim: Develop a procedure for care and maintenance of CVC in patients at Oslo
University Hospital to reduce the number of infections. The procedure aims to
include hygienically aspects, care and maintenance.
Methods: A systematic study of literature, were all available evidence based
knowledge relevant to our aim is critically summarized. AGREE has been used to
evaluate both the available and relevant research and the procedure. An
interdisciplinary group representing different specialities collaborated in the
process.
Results: Use a non-touch technique or aseptic non-touch technique when handling
the CVC. Never touch key parts. The CVC must be secured with sutures and
transparent sterile dressing. CVC placement in centimeters should daily be
documented in the patient record. The transparent sterile CVC dressing should
not be changed more often than every 7th day, unless it is contaminated or
loose. Control insertion site daily for signs of infections. Connectors and
infusion lines should be changed every 3rd day, but daily be bathed in
Chlorhexidine 5 mg/ml. When flushing the CVC, use press-pause technique. Lock
the catheter with a positive pressure technique. Use heparin lock if the CVC is
not daily in use.
Conclusion:This procedure aims to reduce the number of infections related to
CVC. Based on available research, we developed a procedure which summaries the
best care and management of CVC`s. To avoid CRBSI in CVC`s, updated evidence
based guidelines must be implemented.