Alkol içerikli koruyucu kapak kullanımının kan dolaşımı enfeksiyonlarının önlenmesindeki etkinliğinin belirlenmesi
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Dosyalar
Tarih
2019
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Maltepe Üniversitesi, Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışma alkol içerikli kateter kapaklarının Santral Venöz Kateter ilişkili Kan Dolaşımı Enfeksiyonu (SVK KDE) üzerindeki etkinliğinin değerlendirilmesi amacıyla ile randomize kontrollü olarak yapıldı. Çalışmanın evrenini bir kamu hastanesinin Koroner Yoğun Bakım Ünitesi‟ nde (KYBÜ) yatan 95 hasta oluşturdu. Araştırmacı tarafından ilgili literatür taranarak hazırlanan Enfeksiyonu Takip Formu ile veriler toplandı.
Acil servisten koroner yoğun bakım ünitesine kabul edilen dahil olma kriterlerine uyan hastalar randomize olarak seçildi. Çalışmaya dahil olan hastalara SVK işleminin yoğun bakım ünitesinde aseptik kurallara uygun olarak yapılması sağlandı.
Müdahale grubundaki hastaların SVK giriş yerlerine izopropil alkol içerikli kapak takıldı. Kontrol grubundaki hastalara ise standart kateter kapağı takıldı. Hastaların ünitede takibi boyunca her SVK erişimi sonrası alkol içerikli kapakların ve normal kapakların değiştirilmesi sağlandı. Kateter pansumanları gazlı bez ile yapıldı ise iki günde bir; Ģeffaf örtüyle yapıldıysa yedi günde bir değiştirildi. Çalışma boyunca hastaların kateter pansumanları nemlendiğinde, bütünlüğü bozulduğunda veya kirlendiğinde ise hemen değiştirildi. Takip süresince 36 santigrat derece altında ya da 38 santigrat derece üzerinde vücut ısısı olan, titreme bulguları olan hastalardan iki şişe aerob, iki şişe de anaerob kan kültürü alındı. Mikrobiyoloji laboratuvarında kültürler çalışıldı.
Alkol içerikli kapakla takip edilmeyen kontrol grubu hastalarının SVK KDE oranının, alkol içeren kapakla takip edilen müdahale grubuna göre 13,7 kat daha yüksek olduğu tespit edildi (p<0.001).
This study was carried out as a randomized controlled trial in order to investigate the effect of spirituous caps on central venous catheter related bloodstream infections. The target population of the study was the hospitalized patients at the coronary intensive care unit of a public hospital. The investigation was completed with the participation of 95 patients. Data was collected through the infection tracking form which the researcher had prepared by reviewing the related literature. The patients who were in conformity with the criteria of involvement in the study and were admitted into coronary intensive care unit from emergency department were randomized. It was assured that central venous catheterization was administered to the patients participated in the study in accordance with the rules of sterilization. Isopropyl alcohol containing caps were used for the central venous catheter puncture sites of the patients being in the experimental group. However, standard catheter caps were used for the patients in the control group. During the patients‟ follow-up at the unit, it was assured that both spirituous and standard caps were changed after each central venous catheter operation. If the catheter dressings were done with gauze, they were changed once two days, but if they were done with blister, they were changed once seven days. Through the study, catheter dressings of the patients were immediately changed when they dampened, disintegrated or became dirty. During follow-up, two bottles of aerob and two bottles of anaerob blood cultures were taken from the patients having the symptoms of less than 36 °C or higher than 38 °C body temperature and shivering. Those cultures were analyzed at the microbiological laboratory. It was found out that the rate of central venous catheter related bloodstream infections of the control group patients who were not followed with spirituous caps was 13,7 times higher than the rate of experimental group patients followed with spirituous caps (p<0.001).
This study was carried out as a randomized controlled trial in order to investigate the effect of spirituous caps on central venous catheter related bloodstream infections. The target population of the study was the hospitalized patients at the coronary intensive care unit of a public hospital. The investigation was completed with the participation of 95 patients. Data was collected through the infection tracking form which the researcher had prepared by reviewing the related literature. The patients who were in conformity with the criteria of involvement in the study and were admitted into coronary intensive care unit from emergency department were randomized. It was assured that central venous catheterization was administered to the patients participated in the study in accordance with the rules of sterilization. Isopropyl alcohol containing caps were used for the central venous catheter puncture sites of the patients being in the experimental group. However, standard catheter caps were used for the patients in the control group. During the patients‟ follow-up at the unit, it was assured that both spirituous and standard caps were changed after each central venous catheter operation. If the catheter dressings were done with gauze, they were changed once two days, but if they were done with blister, they were changed once seven days. Through the study, catheter dressings of the patients were immediately changed when they dampened, disintegrated or became dirty. During follow-up, two bottles of aerob and two bottles of anaerob blood cultures were taken from the patients having the symptoms of less than 36 °C or higher than 38 °C body temperature and shivering. Those cultures were analyzed at the microbiological laboratory. It was found out that the rate of central venous catheter related bloodstream infections of the control group patients who were not followed with spirituous caps was 13,7 times higher than the rate of experimental group patients followed with spirituous caps (p<0.001).
Açıklama
Anahtar Kelimeler
Santral venöz kateter, Kan dolaşımı enfeksiyonu, Alkol içerikli kateter kapağı, Central venous catheter, Bloodstream infections, Alcohol contaminated cap
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Taşdelen Öğülmen, D. (2019). Alkol içerikli koruyucu kapak kullanımının kan dolaşımı enfeksiyonlarının önlenmesindeki etkinliğinin belirlenmesi / The investigation of the effectiveness of the use of spirituous protective caps in the prevention of bloodstream infectious (Yayımlanmamış Yüksek Lisans Tezi). Maltepe Üniversitesi, Sağlık Bilimleri Enstitüsü, İstanbul.
