근거기반 중심정맥 주입요법 간호실무지침 개정
Updates of Evidence-Based Nursing Practice Guidelines for Central Venous Infusion Therapy
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목적: 본 연구는 2017년 발간된 정맥주입요법 실무지침 개정판을 최신 간호실무근거에 따라 개정하기 위해 시행되었다. 방법: 실무지침 갱신 과정은 NICE와 SIGN에 근거하여 개발된 실무지침 갱신 방법론에 따라 22단계를 걸쳐 수행되었다. 이번 개정에서는 중심정맥 주입요법 영역을 갱신하는 것으로 합의되었으며, 말초정맥 주입요법은 추후 개정될 예정이다. 결과: 중심정맥 주입요법 간호실무지침 개정판은 6개 영역, 195개 권고안으로 구성되었다. 영역별 권고안 수는 일반적 지침 11개, 중심정맥관과 부속기구 14개, 중심정맥관 삽입 전 간호 13개, 중심정맥관 삽입 중 간호 30개, 중심정맥관 삽입 후 간호 51개, 합병증 관리 76개이다. 권고안의 권고등급은 A 등급이 29개(14.9%), B 등급이 87개(44.6%), C 등급이 79개(40.5%)였다. 최신근거에 따라 새롭게 개발된 권고안은 37개(19.0%)이며 주요 개정이 이루어진 권고안은 23개(12.3%)였다. 새롭게 개발된 권고안은 주로 중심정맥 주입요법 관련 감염관리 영역이었다. 결론: 이번 간호실무지침 개정판은 안전한 중심정맥 주입요법 유지에 관한 지침이다. 이 간호실무지침을 통하여 중심정맥 주입요법과 관련된 합병증의 발생이 최소화되고 간호실무가 표준화되어 업무의 효율성이 향상되기를 희망한다.
Abstract
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.
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