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1、ShowerandNo-DressingTechniqueForTunneledCentralVenousContinuingNursingEducationHemodialysisCatheters:AQualityImprovementInitiativeJulieAnnLawrenceBarbaraWilsonSuzanneSeilerLoriHarwoodunneledcentralvenouscathe-Copyright2014AmericanNephrologyNurses’Ass
2、ociationters(CVCs)havebeenusedforTsometimeasavascularaccessLawrence,J.A.,Seiler,S.,Wilson,B.,&Harwood,L.(2014).Showerandno-dressingtech-forhemodialysis.CVCsareniquefortunneledcentralvenoushemodialysiscatheters:Aqualityimprovementusedwhenoptimalandmor
3、eperma-initiative.NephrologyNursingJournal,41(1),67-72.nentarteriovenoushemodialysisac-cessiseithernotanoptionornotSelf-carepracticesandquality-of-lifenuancesjuxtaposedourtunneledhemodialysiscen-desiredbythepatient.Theyareoftentralvenouscatheter(CVC)
4、protocols.Despiteouradvice,individualswithCVCswerenotthepreferredvascularaccessbyshowering.Asaqualityimprovementinitiative,wecomparedthestandardCVCdress-healthcareprovidersduetothehighingpracticestothe“showerandno-dressing”technique.After1380catheter
5、monthsassociatedmorbidityandmortality,(n=119)infectionrateswere0.31eventsper1000catheterdays.The“showerandno-oftenrelatedtoinfection.Hemo-dressing”techniqueappearstobeasafeCVCdressingoptionwithimprovedqualityofdialysiscathetersarethemostcom-life,noin
6、creaseininfectionrates,andcost-effectiveness.moncauseofrepeatedlyhighratesofhospitalizationforinfectioninthisKeyWords:Centralvenouscatheters,catheter-relatedbloodstreaminfections,population(UnitedStatesRenalDatapatientsafety,sterilization,dressings,c
7、ontinuousqualityimprove-ment.System[USRDS],2013).Preventingcatheter-relatedbacteremiabeginsGoalwithgoodCVCcare(Lok&Mokrzycki,Todiscusstheoutcomesofaqualityimprovementinitiativeusingtheshowerandno-2011).Anessentialcomponentofthisdressingtechniquefortu
8、nneledhemodialysiscatheters.isthecareoftheCVCexitsiteandCVCexitsitedressingpractices–anObjectivesareainwhichnursingexpertisecan1.Discussinterventionsimplementedinthe“showerandno-dressing”techniqueproject.directlyimpactpatientoutcomes.2.Reviewthepatie