靜脈導管臨床照護指引

Clinical Practice Guidelines for Intravenous Therapy

張黎露(Li-Lu Chang) ； 周文珊(Wen-Shan Chou) ； 江孟冠(Meng-Kuan Chiang) ； 王齡鈴(Ling-Ling Wang) ； 李宜恬(I-Tien Lee) ； 辜馨儀(Hsin-Yi Ku)

《腫瘤護理雜誌》 Volume 22增訂刊 (2022/10) Pp. 5-58

https://doi.org/10.6880/TJON.202210/SP_22.01

Abstracts

本指引目的是提供具實證依據的照護原則，以支持臨床護理師提供最好的導管照護，維護病人安全和照護品質。這個指引針對臨床常用的靜脈導管包括：周邊置入中心靜脈導管（peripheral inserted central catheter, PICC）、植入式中心靜脈導管（implantable venous access device, 或Port）、隧道式中心靜脈導管（tunneled central venous catheter, 或Hickman®），和周邊靜脈導管（peripheral inserted catheter, PIC）等。指引發展團隊根據四大主軸：導管本身、評估監測、導管功能維護、併發症預防和處理等，系統性搜尋近十年文獻，經過評讀、篩選、統合整理、擬出臨床建議，最後再經由專家共識而產出最後的建議，過程力求嚴謹，以確認指引內容的正確性和可靠性，以期提供給護理人員完整的資訊和照護建議。需要注意的是，指引的目的在於提供最新的實證依據和臨床建議，支持護理人員做臨床決策，而不是取代個別病人的評估以及臨床判斷。這個指引也可以提供機構在發展或修訂導管相關照護標準時的參考依據。

Keywords

臨床照護指引 ； 周邊置入中心靜脈導管 ； 植入式中心靜脈導管 ； 隧道式中心靜脈導管 ； 周邊靜脈導管

Parallel abstracts

These practice guidelines aim to support clinical nurses in providing evidence-based care to patients with central venous catheters or peripheral intravenous catheters, ensuring patient safety and quality of care. Within the scope of intravenous therapies, the guidelines include the peripheral inserted central catheter (PICC), implantable venous access device (or Port), and tunneled central venous catheter (or Hickman®), as well as the peripherally inserted catheters (PICs). A literature search on the selection of intravascular devices, care and maintenance, and strategies related to the preventing and managing of complications was performed via PubMed, EBSCO, and Cochrane Library databases from 2011 to 2021. After reviewing and selecting studies, appraising, synthesizing, and formulating recommendations, a clinical expert panel proposed and reviewed the final draft to ensure the guidelines were as accurate and reliable as possible. The guidelines are intented are to provide up-to-date, evidence-based advice to support nurses in making clinical decisions, and not to replace the individual patient assessments or clinical judgments. The guidelines may also serve as a reference for organizations as they develop or revise catheter-related standards of practice.

Parallel keywords

Clinical practice guidelines ； PICC ； Port ； Hickman ； peripheral inserted catheter

References

Rosenthal V, Kanj S, Desse J. Bundle of the International Nosocomial Infection Control Consortium (INICC) to prevent central and peripheral line-related bloodstream infections. Infection Control and Hospital Epidemiology. 2019.

Biffi R. Introduction and overview of PICC history. In: Peripherally inserted central venous catheters. Milano: Springer; 2014:1-6.

Krein SL, Saint S, Trautner BW, et al. Patient-reported complications related to peripherally inserted central catheters: A multicentre prospective cohort study. BMT Quality & Safety. 2019;28(7):574-581.

鄭如芬, 周佩君．護理人員執行超音波導引周邊置入中心靜脈導管之發展．腫瘤護理雜誌 . 2013;13(1):41-50.

Baskin KM, Hunnicutt, C., Beck, M. E., Cohen, E. D., Crowley, J. J., & Fitz, C. R. Longterm central venous access in pediatric patients at high risk: conventional versus antibiotic–impregnated catheters. Journal of Vascular and Interventional Radiology. 2014;35(3):411-418.