혈액투석 환자의 기능부전 도관관리 실무지침개발
Development of a Practice Guideline for Catheter Dysfunction in Hemodialysis Patients
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목적: 본 연구의 목적은 혈액투석환자의 기능부전 도관관리를 위한 근거기반 실무지침을 개발하기 위함이다. 방법: 실무지침의 개발은 보건의료연구원에서 개발한 임상진료지침 개발 매뉴얼(de novo development)의 12단계에 따라 진행하였다. 결과: 본 지침은 5개 영역 14개 권고안으로 구성되었다. 영역별로 혈액투석도관 기능의 사정을 위한 권고안 3개, 투석도관 기능호전을 위한 보존적 중재 권고안 1개, 도관 기능호전을 위한 약물적 중재에 대한 권고안 7개, 도관 기능 호전평가 권고안 1개, 도관 기능의 지속적 유지관리를 위한 권고안 2개이다. 이들 권고안에 대한 권고등급은 A 등급이 1개 (7.15%), B 등급이 13개 (92.85%), C 등급이 0개 (0%)였다. 결론: 본 지침은 근거기반실무를 위해 개발되었다. 본 연구 결과로 도관기능부전을 가진 혈액투석환자의 간호의 향상을 위해 간호사들에게 공유되기를 바란다.
Abstract
Purpose: This study was done to develop an evidence-based practice guideline for catheter dysfunction in hemodialysis patients. Methods: Development of the guideline process was done according to the De Novo development version 1.0 by NECA which consists of 12 steps. Results: The developed guideline consisted of 5 domains and 14 recommendations. The number of recommendations for each domain were: 3 on catheter dysfunction assessment, 1 on conservative management of catheter dysfunction, 7 on drug management of catheter dysfunction, 1 on catheter function test and 2 onmaintenancemanagement. Of the recommendations, 7.15% were marked as A grade, 52.85% of B grade, and 50% of C grade. Conclusion: Findings in this study indicate that this guideline can be added to the evidence-based practice guidelines for fundamentals of practice and that this guideline can be disseminated to nurses nationwide in order to improve the care of hemodialysis patients with catheter dysfunction
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