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Educare

Educare

OCTUBRE 2004 N° 7 Volumen 2

Nursing management of a central line and incidence of catheter-associated infections

Section: TEACHING TO LEARN

Authors

Jorge Carbajal Ariza

Position

Licenciado en Enfermería. Escuela de Enfermería Padre Luis Tezza. Universidad Ricardo Palma. Lima, Perú.

Contact email: jorgecarbajal_2002@hotmail.com

Abstract

The aim of this longitudinal-section, correlational, descriptive, prospective study was to determine the existing relationship between the management of a central line on the part of the nursing staff working at the "Artificial Nutritional Support Unit" of the "Hospital Nacional Guillermo Almenar Irigoyen" and the incidence of infection associated with the catheter in 22 patients in whom 40 central venous catheters were inserted.
Subject selection for the study was carried out in accordance with the non-probabilistic intentional-type method and on the basis of inclusion and exclusion criteria.
The most outstanding results were as follows: 87% of the catheters were categorised as "easily managed" and 12.1% as "very easily managed" in accordance with pre-established observational guidelines that included 20 items relating to the asepsis and antisepsis criteria, dressing change frequency every 48 hours, change of the flask-bag, and complete protocol to be followed in Total Parenteral Nutrition (TPN), as well as the use of devices such as flow rate regulators, double-channel lines and endovenous filters.
65% of the catheters were inserted into the subclavian vein while 35% were inserted into the internal jugular vein. Catheter-associated infections reached the 35% mark while bacterial catheter-associated infections reached 22.5%. The predominant germs found were staphylococcus aureus (85.7%) and candida albicans (14.3%).
The most relevant conclusions were that nurses working at the "Artificial Nutritional Support Unit" apply asepsis and antisepsis measures before, during and after the procedure in patients with a central line for TPN purposes. These measures did not hinder significantly the results of catheter tip positive cultures. However, the negative results show high percentages of catheter-associated infections, which comes to demonstrate that the nursing management is not a causal factor of great magnitude. As insufficient evidence exists, the presented hypothesis that nursing management is directly related to the incidence of catheter-associated infections (CAIs) is therefore rejected, and that both variabilities behave independently from each other.

Keywords:

management of a central line; total parenteral nutrition; catheter-associated infections; bacterial infections associated with the catheterinclusion and exclusion criteria

Versión en Español

Título:

Manejo de la vía central por enfermería e incidencia de infecciones asociadas al catéter