정맥주입요법 간호실무지침 개정
Updates of Nursing Practice Guideline for Intravenous Infusion
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초록
연구목적: 정맥주입요법 간호실무지침에 대한 갱신 필요성을 평가하고, 평가결과 갱신이 필요한 것으로 판단되어 근거 기반의 정맥주입요법 간호실무지침 개정판을 개발하고자 한다. 연구방법: 본 연구에서 정맥주입요법 간호실무지침의 개정은 실무지침 갱신그룹이 NICE와 SIGN에서 개발한 매뉴얼에 따라 간호분야 실무지침의 갱신 방법론을 확정하고, 확정된 실무지침 갱신 방법론대로 22단계에 걸쳐 시행되었다. 연구결과: 정맥주입요법 간호실무지침 개정판은 23개 영역, 322개 권고안으로 구성되었다. 영역별 권고안 수를 보면 일반적 지침 4개, 정맥관 선정 12개, 정맥관 삽입부위 선정 및 확인 20개, 정맥관 삽입 시 간호 9개, 정맥관 삽입부위 간호 54개, 정맥관 개방성 유지 21개, 정맥관을 통한 채혈 4개, 정맥관과 정맥주입기구의 사용, 교환 및 제거 33개, 정맥주입 부속기구 사용 28개, 정맥주입관련감염 15개, 정맥염 6개, 침윤/일혈 11개, 공기색전 11개, 정맥관 색전 5개, 중심정맥관 관련 정맥혈전증 10개, 중심정맥관 위치이상 8개, 신경손상 6개, 항암제 주입 7개, PCA 주입 8개, 정맥영양지원 24개, 수혈요법 17개, 교육 7개, 기록과 보고 2개의 권고안으로 구성되었다. 정맥주입요법 실무지침 초판(2012)과 비교 시 A 등급의 권고는 11.9%에서 15.9%로 증가하였으며 C 등급의 권고는 59.7%에서 53.9%로 감소하였다. 새로운 권고안이 178개(51.6%), 주요 개정이 30개(8.7%), 소규모 개정이 70개(20.3%), 개정 없음이 67개(19.3%)였으며, 삭제된 권고안은 24개였다. 결론: 정맥주입요법 간호실무지침 개정판이 병원간호사회를 통해 전국의 병원 간호부에 확산되면 간호사의 매일의 정맥주입간호실무가 보다 최신의, 과학적인 근거를 기반으로 수행되고, 표준화되며, 업무의 효율성이 개선되는데 크게 기여할 수 있을 것으로 생각된다.
Abstract
Purpose: This study was conducted to update the existing nursing practice guideline for intravenous infusion guidelines according to the evidence-based practice guideline in South Korea. Methods: Guideline update process was performed using 22 steps according to the manuals developed by NICE and SIGN. Results: Updated nursing practice guidelines for the intravenous infusion were consisted of 23 domains and 322 recommendations. The number of recommendations in each domain were 4 for general instruction, 12 for vascular access device selection, 20 for site selection, 9 for insertion, 54 for stabilization, 21 for maintaining patency, 4 for blood sampling, 33 for exchange and removal, 28 for add-on device selection, 28, 72 for infusion related complications, 56 for infusion therapies, 7 for education, and 2 for documentation and report. There were 15.9% of A, 30.2% of B, 53.9% of C in terms of grade recommendations. A total of 178 (51.6%) recommendations were newly developed and 24 previous recommendations have been deleted. Conclusion: Updated nursing practice guideline for intravenous infusion was expected to be an evidence-based practice guideline for intravenous infusion in South Korea. This guideline is suggested to be disseminated to clinical nursing settings nationwide to improve the efficiency of intravenous infusion practice.
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