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Effect of Evidence-Based Practice Protocol for Catheter Dysfunction in Hemodialysis Patients: Focus on Patency Rates and Bleeding Complications

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KMID : 1004620180240030356
ÀÌ°æ¹Ì ( Lee Kyung-Mi ) - »ï¼º¼­¿ïº´¿ø

±è¹Ì¿¬ ( Kim Mi-Yeon ) - »ï¼º¼­¿ïº´¿ø

Abstract

¸ñÀû: ÀÌ ¿¬±¸´Â Ç÷¾×Åõ¼®È¯ÀÚÀÇ µµ°ü ±â´ÉºÎÀü °ü¸® ÇÁ·ÎÅäÄÝ Àû¿ë ÈÄ µµ°ü °³Á¸À² ¹× ÃâÇ÷ÇÕº´ÁõÀ» ¾Ë¾Æº¸±â À§ÇÑ ÈÄÇâÀû ÄÚȣƮ ¿¬±¸ÀÌ´Ù.

¹æ¹ý: ¼­¿ï 1°³ ´ëÇк´¿ø¿¡¼­ µµ°ü ±â´ÉºÎÀüÀ» °æÇèÇÑ 94¸íÀÇ È¯ÀÚ¸¦ ÈÄÇâÀûÀ¸·Î ºÐ¼®ÇÏ¿´À¸¸ç, ´ëÁ¶±º 55¸í°ú ÇÁ·ÎÅäÄÝ ±×·ì 39¸íÀÌ´Ù. ÇÁ·ÎÅäÄÝÀº Ç÷¾×Åõ¼®µµ°ü ±â´ÉÀÇ »çÁ¤, Åõ¼®µµ°ü ±â´ÉÈ£ÀüÀ» À§ÇÑ º¸Á¸Àû ÁßÀç, µµ°ü ±â´ÉÈ£ÀüÀ» À§ÇÑ ¾à¹°Àû ÁßÀç, µµ°ü ±â´É È£ÀüÆò°¡, µµ°ü ±â´ÉÀÇ Áö¼ÓÀû À¯Áö°ü¸®¸¦ À§ÇÑ ±Ç°í¾ÈÀ¸·Î ±¸¼ºµÇ¾î ÀÖ´Ù. ¼öÁýµÈ µ¥ÀÌÅÍ´Â SPSS 23.0 ÇÁ·Î±×·¥À» ÅëÇØ ±â¼ú Åë°è, t-°ËÁ¤, Chi-square°ËÁ¤À» »ç¿ëÇÏ¿´´Ù.

°á°ú: ÇÁ·ÎÅäÄÝ ±×·ìÀÇ µµ°ü °³Á¸À²Àº ´ëÁ¶±º¿¡ ºñÇØ À¯ÀÇÇÏ°Ô ³ô¾ÒÀ¸¸ç, ÃâÇ÷ ÇÕº´ÁõÀº Åë°èÀûÀ¸·Î À¯ÀÇÇÏÁö ¾Ê¾Ò´Ù.

°á·Ð: ÇÁ·ÎÅäÄÝÀÇ Àû¿ëÀº ÃâÇ÷ ÇÕº´Áõ ¾øÀÌ Ä«Å×ÅÍÀÇ °³Á¸À²À» À¯ÀÇÇÏ°Ô ³ôÀÌ´Â °á°ú¸¦ °¡Á®¿Ô´Ù. °¡À̵å¶óÀÎÀÌ Ç÷¾×Åõ¼® ȯÀÚÀÇ µµ°ü ±â´É Çâ»óÀ» À§ÇØ ¸¹Àº °£È£»ç¿¡°Ô À¯¿ëÇÏ°Ô »ç¿ëµÇ±â¸¦ ¹Ù¶õ´Ù.

Purpose: This study was a retrospective cohort study to evaluate the effect of evidence-based guidelines for catheter dysfunction among hemodialysis patients, Success rate and bleeding complications in catheterization were examined.
Methods: We performed a retrospective cohort study, including 94 patients with catheter dysfunction who were receiving hemodialysis at a university hospital; 55 in the control group and 39 in the protocol group. This protocol was composed of the catheter dysfunction assessment, conservative management of catheter dysfunction, drug management of catheter dysfunction, catheter function test and maintenance management. Data were analyzed with a Chi-square test and t-test using SPSS/WIN 23.0 program.

Results: The patency rate of the protocol group was significantly higher than that of the control group. The rate of bleeding complications was not statistically significant for either the control group or the protocol group before or after application.
Conclusion: The application of the guidelines effectively increased the patency rate of the catheter without bleeding complications. It is hoped that this guideline can be disseminated to nurses nationwide to improve the efficiency of catheter function for hemodialysis patients.
KeyWords
ÃâÇ÷ÇÕº´Áõ , µµ°ü±â´ÉºÎÀü, µµ°ü°³Á¸, Ç÷¾×Åõ¼®
Bleeding, Catheter Obstruction, Patency, Renal Dialysis
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ÇмúÁøÈïÀç´Ü(KCI)