Öz
Bu derleme, hemşire yönetimli kateter çıkarma protokollerinin üriner infeksiyonlar üzerine etkisini araştıran çalışmaları incelemek amacıyla ele alındı. Yöntem: Literatür taraması PubMed, ScienceDirect, Scopus, Google Scholar, OVID veri tabanlarında anahtar kelimeler kullanılarak, bilgisayar ortamında yapıldı. Tarama, 2000-2018 yılları arasında basım dili Türkçe ve İngilizce olan çalışmalarla sınırlıdır. Bulgular: Kateterlerin düzenli olarak değerlendirilmesinin, karar verme algoritması, kateter hatırlatıcı ve hemşire yönetimli protokollerin kateterle ilişkili üriner sistem infeksiyonları (Kİ-ÜSİ) oranlarını azalttığı çeşitli çalışmalarda gösterilmektedir. Helber (2015) kanıta dayalı kateter çıkarma protokolünün kullanımının kateter kalış süresi ve Kİ-ÜSİ oranına etkisini incelemek amacıyla yaptığı çalışma sonucunda, kateter çıkarma protokolünün kullanımının kateter kalış süresini 2846 günden 2383 güne ve Kİ-ÜSİ oranını da 6.32’den 2.52’ye düşürdüğünü belirlemiştir. Gordon’un (2015) Kİ-ÜSİ’nin önlenmesinde hemşirelere verilen eğitimin etkisini incelediği çalışmada, eğitim öncesi Kİ-ÜSİ oranının 1000 kateter gününde 10.47 olduğu, eğitimden sonra Kİ-ÜSİ gelişmediği, hemşirelere verilen eğitim ile Kİ-ÜSİ oranları arasında istatiksel anlamda ilişki olduğunu belirtmiştir. Sonuç: İncelenen çalışmalarda hemşire yönetimli kateter çıkarma protokollerinin kullanımının kateter kalış süresi ve Kİ-ÜSİ hızını azalttığı görüldü. Bu sonuçlar doğrultusunda Kİ-ÜSİ’nin önlenmesi amacıyla üriner kateterlerin uygunsuz kullanımını ve hastada uzun süre kalmasını önlemek için kateter çıkarma protokollerinin geliştirilmesi, uygulamaya yansıtılması ve kanıta dayalı uygulamaların hasta bakımına yansıtılmasında önemli role sahip olan hemşireler tarafından kateter çıkarma protokollerinin kullanımının yaygınlaştırılması önerilebilir.
Anahtar Kelimeler
Hemşire yönetimli kateter çıkarma protokolü kalite geliştirme kateter ile ilişkili üriner sistem infeksiyonu
Kaynakça
- 1. Kundakci A., Özkalayci Ö., Zeyneloglu P., Arslan H., Pirat A. (2014): Bir cerrahi yoğun bakım ünitesinde nozokomiyal enfeksiyonların risk faktörleri/ Risk factors for nosocomial infections in a surgical intensive care unit. Türk Yoğun Bakım Derneği Dergisi;12(1):25-35. 2. Erdinç F.Ş., Yılmaz G.R., Dizbay M., Beyazıt F.N., Kalkancı A. (2014): Kateterle ilişkili üriner sistem infeksiyonları-CDC 2014. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi;19(3):105-117. 3. Fink R., Gilmartin H., Richard A., Capetuzi E., Boltz M., Wald H. (2012): Indwelling urinary catheter management and catheter associated urinary tract infection prevention practices in nurses ımproving care for health system elders hospital. American Journal of Infection Control;40:715-720. 4. Yatim J., Wong K.S., Ling M.L., Tan S.B., Tan K.Y., Hockenberry M. (2016): A nursedriven process for timely removal of urinary catheters. International Journal of Urological Nursing;10(3):167-172. 5. Institute for Healthcare Improvement (2011): How-to guide: prevent catheter-associated urinary tract infections. Erişim yeri:http://docplayer.net/10285056-How-to-guide-prevent-catheter-associated-urinary-tract-infections.html, Erişim tarihi:19.11.2017. 6. Arda B., Ateş K., Bakır M., Güven M., Karakoç E., Özinel M.A., Pirat A., Şenkul T. (2012): Üriner kateter infeksiyonlarının önlenmesi kılavuzu. Hastane İnfeksiyonları Dergisi; 16(1):1-18. 7. Newman D.K. (2010): Prevention and management of catheter-associated UTIs. In: Infectious Disease. Special Edition. 8. Andrade V.L.F., Fernandes F.A.V. (2016): Prevention of catheter-associated urinary tract infection: implementation strategies of international guidelines. Revista Latino-Americana De Enfermagem;24:e2678. 9. Gokula M., Gaspar P.M. (2014): Implementation of the FIRM (foley insertion, removal, and maintenance) protocol in skilled nursing facilities. Translation: The University of Toledo Journal of Medical Sciences;1(1):10-12. 10. Fuchs M.A., Sexton D.J., Thornlow D.K., Champangne M.T. (2011): Evaluation of an evidence based nurse driven checklist to prevent hospital acquired catheter associated urinary tract infections in intensive care units. Journal of Nursing Care Quality;26(2):101-109. 11. Tissot E., Limat S., Cornette C., Capallier G. (2001): Risk factors for catheter associated bacteriuria in a medical intensive care unit. European Journal of Clinical Microbiology Infectious Disease;20(4):260-262. 12. Colau A., Lucet J.C., Rufat P., Botto H., Benoit G., Jardin A. (2001): Incidence and risk factors of bacteriuria after transurethral resection of the prostate. European Urology;39(3): 272-276. 13. Topal J., Conklin S., Camp K., Balcezak T., Herbert P.(2005): Prevention of nosocomial catheter associated urinary tract infections through computerized feedback to physicians and nurse directed protocol. American Journal of Medical Quality;20(3):121-126. 14. Reilly L., Sullivan P., Ninni S., Fochesto D., Williams K., Fetherman B. (2006): Reducing foley catheter device days in an intensive care unit. Using the evidence to change practice. AACN Advanced Crtitical Care;17(3):272-283. 15. Apisarnthanarak A., Rutjanawech S., Wichansawakun S., Ratanabunjerdkul H., Patthranitima P., Thongphubeth K., Suwannakin A., Warren D.K., Fraser VJ. (2007): Initial inappropriate urinary catheters use in a tertiary-care center: incidence, risk factors, and outcomes. American Journal of Infection Control;35(9):594-599. 16. Fakih M.G., Watson S.R., Greene M.T., Kennedy E.H., Olsted R.N., Krein S.L., Saint S. (2012): Reducing inappropriate urinary catheter use: a statewide effort. Archives of Internal Medicine;172(3):255-260. 17. Elpern E.H., Killeen K., Ketchem A., Wiley A., Patel G., Lateef O. (2009): Reducing use of indwelling urinary catheters and associated urinary tract infections. American Journal of Critical Care ;18(6):535-542. 18. Prayle H., Thompson M., Lancaster S., Molyneux R., Tsang J. (2014): Early removal of urinary catheters in patients with hip fracture using the Houdini (B) checklist. Age and Aging;43(1):i1-18. 19. Alexaitis I., Broome B. (2014): Implementation of a nurse-driven protocol to prevent catheter-associated urinary tract infections. Journal of Nursing Care Quality;29(3):245-252. 20. Schneider M.A. (2012): Prevention of catheter associated urinary tract infections in patients with hip fractures through education of nurses to spesific catheter protocols. Orthopedic Nursing;1(1):12-18. 21. Kanj S.S., Zahreddine N., Rosenthal V.D., Alamuddin L., Kanafani Z., Moleab B. (2013): Impact of a multidimensional infection control approach on catheter associated urinary tract infection rates ina an adult intensive care unit in Lebanon. International Nosocomial Infection Control Consortium (INICC) findings. Journal of Infectious Disease;17(9):686-690. 22. Galiczewski J.M. (2016): Interventions for the prevention of catheter associated urinary tract infections in intensive care units: an integretive review. Intensive and Critical Care Nursing;32:1-11. 23. Purvis S., Gion T., Kennedy G., Rees S., Safdar N., Vandenbergh S., Weber J. (2014): Catheter associated urinary tract infection. Journal of Nursing Care Quality; 29(2):141-148. 24. Helber-Cassady B. (2015): The impact of an evidence-based practice protocol on catheter-associated urinary tract infections and urinary catheter days. The Ohio State University, 2015. Erişim yeri:https://kb.osu.edu/dspace/handle/1811/68662, Erişim tarihi:19.11.2017. 25. Gordon P.R. (2015): The effects of nursing education on decreasing catheter associated urinary tract infection rates. Walden dissertations an doctoral studies, Walden University. Erişim yeri: https://scholarworks.waldenu.edu/cgi/viewcontent.cgi?referer=&httpsredir=1&article=1582&context=dissertations, Erişim tarihi:19.11.2017. 26. Dy S., Major-Joynes B., Pegues D., Bradway C. (2016): A nurse-driven protocol for removal of indwelling urinary catheters across a multi-hospital academic healthcare system. Urologic Nursing;36(5):243-250.
Öz
This review was conducted to review the studies investigating the effects of the nurse-driven protocols for catheter removal on urinary tract infections.Method: Literature review was done in the computer environment using key words in the PubMed, ScienceDirect, Scopus, Google Scholar, and OVID databases. The review is limited to studies issued in Turkish and English from 2000 to 2018.Results: Several studies have shown that regular monitoring of the catheters, decision-making algorithm, catheter reminder and nurse-driven protocols reduce catheter associated urinary tract infections (CAUTI) rates. Helber (2015), as a result of a study investigating the effect of the use of the evidence-based protocol for catheter removal on the indwelling time of the catheter and CAUTI rate, has found out that the use of the evidence-based protocol for catheter removal reduced the indwelling time of the catheter from 2846 days to 2383 days and CAUTI rate from 6.32 to 2.52. Gordon (2015), in a study investigating the effect of training given to nurses to prevent CAUTI, has suggested that CAUTI rate before training was 10.47 on catheter day 1000, no CAUTI emerged after training and there was a statistically significant relationship between the training given to nurse and CAUTI rates. Conclusıon: As a result of the review of studies, it was found out that the use of the nurse-driven protocols for catheter removal reduces the indwelling time and CAUTI rate. Based on these results, it may be suggested to develop protocols for catheter removal in order to prevent improper use of urinary catheters and prolonged indwelling time of them in patients, implement the protocols and promote the protocols for catheter removal by nurses who have an important role in projecting them into practice and in reflecting evidence-based applications into patient care.
Kaynakça
- 1. Kundakci A., Özkalayci Ö., Zeyneloglu P., Arslan H., Pirat A. (2014): Bir cerrahi yoğun bakım ünitesinde nozokomiyal enfeksiyonların risk faktörleri/ Risk factors for nosocomial infections in a surgical intensive care unit. Türk Yoğun Bakım Derneği Dergisi;12(1):25-35. 2. Erdinç F.Ş., Yılmaz G.R., Dizbay M., Beyazıt F.N., Kalkancı A. (2014): Kateterle ilişkili üriner sistem infeksiyonları-CDC 2014. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi;19(3):105-117. 3. Fink R., Gilmartin H., Richard A., Capetuzi E., Boltz M., Wald H. (2012): Indwelling urinary catheter management and catheter associated urinary tract infection prevention practices in nurses ımproving care for health system elders hospital. American Journal of Infection Control;40:715-720. 4. Yatim J., Wong K.S., Ling M.L., Tan S.B., Tan K.Y., Hockenberry M. (2016): A nursedriven process for timely removal of urinary catheters. International Journal of Urological Nursing;10(3):167-172. 5. Institute for Healthcare Improvement (2011): How-to guide: prevent catheter-associated urinary tract infections. Erişim yeri:http://docplayer.net/10285056-How-to-guide-prevent-catheter-associated-urinary-tract-infections.html, Erişim tarihi:19.11.2017. 6. Arda B., Ateş K., Bakır M., Güven M., Karakoç E., Özinel M.A., Pirat A., Şenkul T. (2012): Üriner kateter infeksiyonlarının önlenmesi kılavuzu. Hastane İnfeksiyonları Dergisi; 16(1):1-18. 7. Newman D.K. (2010): Prevention and management of catheter-associated UTIs. In: Infectious Disease. Special Edition. 8. Andrade V.L.F., Fernandes F.A.V. (2016): Prevention of catheter-associated urinary tract infection: implementation strategies of international guidelines. Revista Latino-Americana De Enfermagem;24:e2678. 9. Gokula M., Gaspar P.M. (2014): Implementation of the FIRM (foley insertion, removal, and maintenance) protocol in skilled nursing facilities. Translation: The University of Toledo Journal of Medical Sciences;1(1):10-12. 10. Fuchs M.A., Sexton D.J., Thornlow D.K., Champangne M.T. (2011): Evaluation of an evidence based nurse driven checklist to prevent hospital acquired catheter associated urinary tract infections in intensive care units. Journal of Nursing Care Quality;26(2):101-109. 11. Tissot E., Limat S., Cornette C., Capallier G. (2001): Risk factors for catheter associated bacteriuria in a medical intensive care unit. European Journal of Clinical Microbiology Infectious Disease;20(4):260-262. 12. Colau A., Lucet J.C., Rufat P., Botto H., Benoit G., Jardin A. (2001): Incidence and risk factors of bacteriuria after transurethral resection of the prostate. European Urology;39(3): 272-276. 13. Topal J., Conklin S., Camp K., Balcezak T., Herbert P.(2005): Prevention of nosocomial catheter associated urinary tract infections through computerized feedback to physicians and nurse directed protocol. American Journal of Medical Quality;20(3):121-126. 14. Reilly L., Sullivan P., Ninni S., Fochesto D., Williams K., Fetherman B. (2006): Reducing foley catheter device days in an intensive care unit. Using the evidence to change practice. AACN Advanced Crtitical Care;17(3):272-283. 15. Apisarnthanarak A., Rutjanawech S., Wichansawakun S., Ratanabunjerdkul H., Patthranitima P., Thongphubeth K., Suwannakin A., Warren D.K., Fraser VJ. (2007): Initial inappropriate urinary catheters use in a tertiary-care center: incidence, risk factors, and outcomes. American Journal of Infection Control;35(9):594-599. 16. Fakih M.G., Watson S.R., Greene M.T., Kennedy E.H., Olsted R.N., Krein S.L., Saint S. (2012): Reducing inappropriate urinary catheter use: a statewide effort. Archives of Internal Medicine;172(3):255-260. 17. Elpern E.H., Killeen K., Ketchem A., Wiley A., Patel G., Lateef O. (2009): Reducing use of indwelling urinary catheters and associated urinary tract infections. American Journal of Critical Care ;18(6):535-542. 18. Prayle H., Thompson M., Lancaster S., Molyneux R., Tsang J. (2014): Early removal of urinary catheters in patients with hip fracture using the Houdini (B) checklist. Age and Aging;43(1):i1-18. 19. Alexaitis I., Broome B. (2014): Implementation of a nurse-driven protocol to prevent catheter-associated urinary tract infections. Journal of Nursing Care Quality;29(3):245-252. 20. Schneider M.A. (2012): Prevention of catheter associated urinary tract infections in patients with hip fractures through education of nurses to spesific catheter protocols. Orthopedic Nursing;1(1):12-18. 21. Kanj S.S., Zahreddine N., Rosenthal V.D., Alamuddin L., Kanafani Z., Moleab B. (2013): Impact of a multidimensional infection control approach on catheter associated urinary tract infection rates ina an adult intensive care unit in Lebanon. International Nosocomial Infection Control Consortium (INICC) findings. Journal of Infectious Disease;17(9):686-690. 22. Galiczewski J.M. (2016): Interventions for the prevention of catheter associated urinary tract infections in intensive care units: an integretive review. Intensive and Critical Care Nursing;32:1-11. 23. Purvis S., Gion T., Kennedy G., Rees S., Safdar N., Vandenbergh S., Weber J. (2014): Catheter associated urinary tract infection. Journal of Nursing Care Quality; 29(2):141-148. 24. Helber-Cassady B. (2015): The impact of an evidence-based practice protocol on catheter-associated urinary tract infections and urinary catheter days. The Ohio State University, 2015. Erişim yeri:https://kb.osu.edu/dspace/handle/1811/68662, Erişim tarihi:19.11.2017. 25. Gordon P.R. (2015): The effects of nursing education on decreasing catheter associated urinary tract infection rates. Walden dissertations an doctoral studies, Walden University. Erişim yeri: https://scholarworks.waldenu.edu/cgi/viewcontent.cgi?referer=&httpsredir=1&article=1582&context=dissertations, Erişim tarihi:19.11.2017. 26. Dy S., Major-Joynes B., Pegues D., Bradway C. (2016): A nurse-driven protocol for removal of indwelling urinary catheters across a multi-hospital academic healthcare system. Urologic Nursing;36(5):243-250.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Derleme |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Ağustos 2018 |
| Yayımlandığı Sayı | Yıl 2018Cilt: 3 Sayı: 1 |
