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Updates of Evidence-Based Nursing Practice Guidelines for Central Venous Infusion Therapy

ÀÓ»ó°£È£¿¬±¸ 2023³â 29±Ç 1È£ p.42 ~ 55
KMID : 1004620230290010042
ÀÓ°æÃá ( Lim Kyung-Choon ) - 

Á¤Àç½É ( Jeong Jae-Sim ) - 
±è°æ¼÷ ( Kim Kyeong-Sug ) - 
±èÇö¸² ( Kim Hyun-Lim ) - 
±èÇöÁ¤ ( Kim Hyun-Jeong ) - 
±èµ¿¿¬ ( Kim Dong-Yeon ) - 
À̹ÌÁ¤ ( Lee Mi-Jeong ) - 
ÀÌÁÖÇö ( Lee Joo-Hyun ) - 

Abstract

¸ñÀû: º» ¿¬±¸´Â 2017³â ¹ß°£µÈ Á¤¸ÆÁÖÀÔ¿ä¹ý ½Ç¹«Áöħ °³Á¤ÆÇÀ» ÃֽŠ°£È£½Ç¹«±Ù°Å¿¡ µû¶ó °³Á¤Çϱâ À§ÇØ ½ÃÇàµÇ¾ú´Ù.

¹æ¹ý: ½Ç¹«Áöħ °»½Å °úÁ¤Àº NICE¿Í SIGN¿¡ ±Ù°ÅÇÏ¿© °³¹ßµÈ ½Ç¹«Áöħ °»½Å ¹æ¹ý·Ð¿¡ µû¶ó 22´Ü°è¸¦ °ÉÃÄ ¼öÇàµÇ¾ú´Ù. À̹ø °³Á¤¿¡¼­´Â Áß½ÉÁ¤¸Æ ÁÖÀÔ¿ä¹ý ¿µ¿ªÀ» °»½ÅÇÏ´Â °ÍÀ¸·Î ÇÕÀǵǾúÀ¸¸ç, ¸»ÃÊÁ¤¸Æ ÁÖÀÔ¿ä¹ýÀº ÃßÈÄ °³Á¤µÉ ¿¹Á¤ÀÌ´Ù.

°á°ú: Áß½ÉÁ¤¸Æ ÁÖÀÔ¿ä¹ý °£È£½Ç¹«Áöħ °³Á¤ÆÇÀº 6°³ ¿µ¿ª, 195°³ ±Ç°í¾ÈÀ¸·Î ±¸¼ºµÇ¾ú´Ù. ¿µ¿ªº° ±Ç°í¾È ¼ö´Â ÀϹÝÀû Áöħ 11°³, Áß½ÉÁ¤¸Æ°ü°ú ºÎ¼Ó±â±¸ 14°³, Áß½ÉÁ¤¸Æ°ü »ðÀÔ Àü °£È£ 13°³, Áß½ÉÁ¤¸Æ°ü »ðÀÔ Áß °£È£ 30°³, Áß½ÉÁ¤¸Æ°ü »ðÀÔ ÈÄ °£È£ 51°³, ÇÕº´Áõ °ü¸® 76°³ÀÌ´Ù. ±Ç°í¾ÈÀÇ ±Ç°íµî±ÞÀº A µî±ÞÀÌ 29°³(14.9%), B µî±ÞÀÌ 87°³(44.6%), C µî±ÞÀÌ 79°³(40.5%)¿´´Ù. Ãֽűٰſ¡ µû¶ó »õ·Ó°Ô °³¹ßµÈ ±Ç°í¾ÈÀº 37°³(19.0%)À̸ç ÁÖ¿ä °³Á¤ÀÌ ÀÌ·ç¾îÁø ±Ç°í¾ÈÀº 23°³(12.3%)¿´´Ù. »õ·Ó°Ô °³¹ßµÈ ±Ç°í¾ÈÀº ÁÖ·Î Áß½ÉÁ¤¸Æ ÁÖÀÔ¿ä¹ý °ü·Ã °¨¿°°ü¸® ¿µ¿ªÀ̾ú´Ù.

°á·Ð: À̹ø °£È£½Ç¹«Áöħ °³Á¤ÆÇÀº ¾ÈÀüÇÑ Áß½ÉÁ¤¸Æ ÁÖÀÔ¿ä¹ý À¯Áö¿¡ °üÇÑ ÁöħÀÌ´Ù. ÀÌ °£È£½Ç¹«ÁöħÀ» ÅëÇÏ¿© Áß½ÉÁ¤¸Æ ÁÖÀÔ¿ä¹ý°ú °ü·ÃµÈ ÇÕº´ÁõÀÇ ¹ß»ýÀÌ ÃÖ¼ÒÈ­µÇ°í °£È£½Ç¹«°¡ Ç¥ÁØÈ­µÇ¾î ¾÷¹«ÀÇ È¿À²¼ºÀÌ Çâ»óµÇ±â¸¦ Èñ¸ÁÇÑ´Ù.

Purpose: This study was conducted to update nursing practice guidelines for intravenous infusion published in 2017.
Methods: The guideline update process was carried out using 22 steps developed by NICE and SIGN.
It was agreed to update domains related to central venous infusion therapy. Contents related to peripheral infusion would be updated later.

Results: Updated guidelines for central venous infusion therapy consisted of 6 domains and 195 recommendations. The number of recommendations by domain was 11 for general instruction, 14 for central vascular access devices (CVAD) and add-on devices, 13 for nursing management before insertion of CVAD, 30 for management during insertion of CVAD, 51 for management after insertionof CVAD, and 76 for complications. A grade was 29 (14.9%), B grade was 87 (44.6%), and C grade was 79 (40.5%) in the strength of recommendations. A total of 37 (19.0%) recommendations were newly developed and 23 (12.3%) previous recommendations have been modified. The newly developed recommendations were mainly related to the infection control methods.

Conclusion: The updated guideline is focused on safe maintenance of central venous infusion therapy. Through this guideline, it is hoped to minimize the occurrence of complications and improve the standardization and efficiency of nursing practice.
KeyWords
Áß½ÉÁ¤¸Æ°ü, Á¤¸ÆÁÖÀÔ, ÀÓ»ó½Ç¹«Áöħ, ±Ù°Å±â¹Ý °£È£
Central Venous Catheters, Intravenous Infusions, Clinical Practice Guideline, Evidence-Based Nursing
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ÇмúÁøÈïÀç´Ü(KCI)