Preprečevanje zapletov pri bolniku z uvedenim radialnim arterijskim katetrom: pregled literature : diplomsko delo

Rutnik, Snježana (author), Ravljen, Mirjam (mentor)

Uvod: Najpogostejše indikacije za uvajanje arterijskega katetra so potreba po pogosti kontroli parametrov v plinski analizi arterijske krvi, laboratorijskih izvidih krvnih vzorcev in pričakovane spremembe arterijskega krvnega tlaka bolnika. Zapleti v povezavi z uvedenim arterijskim katetrom so številni. Pogoste so netočne meritve pri invazivni metodi merjenja krvnega tlaka in netočni laboratorijski izvidi arterijske krvi. Za preprečevanje zapletov v povezavi z arterijskim katetrom je v največji meri odgovorna zdravstvena nega. Namen: Namen diplomskega dela je na teoretični ravni predstaviti preprečevanje zapletov pri bolniku z uvedenim radialnim arterijskim katetrom. Cilj je prikazati posebnosti nadzora in rokovanja z uvedenimi radialnim arterijskim katetrom ter oblikovanje navodil za delo. Metode dela: Uporabljena je bila deskriptivna metoda dela s sistematičnim pregledom ter analizo enot znanstvene in strokovne literature v angleškem in slovenskem jeziku. Iz raziskovanja omenjene literature smo izpeljali rezultate diplomskega dela. Temeljno literaturo v angleškem jeziku smo iskali po podatkovnih bazah CINAHL in PubMed med leti 2006 in 2016. Literaturo v slovenskem jeziku smo iskali s pomočjo vzajemne bibliografsko-kataloške baze podatkov COBIB.SI med leti 2006 in 2016. Pregledali smo še zbornike strokovnih srečanj za medicinske sestre. Rezultati: Rokovanje z arterijskim katetrom brez zapletov je cilj na poti izboljševanja kakovosti in varnosti, kar v praksi pomeni obravnavo bolnika z uporabo metod, ki temeljijo na znanstvenih dokazih in ki jo izvajajo ustrezno usposobljeni izvajalci. Priporočena pogostost nadzora uvedenega radialnega arterijskega katetra je vsaj enkrat v delovni izmeni. Netočni rezultati laboratorijske analize arterijske krvi so posledica kontaminacije krvi, prisotnost zračnik mehurčkov v epruveti ter napačno rokovanje pred in med transportom. Dodajanje heparina v infuzijsko raztopino za prebrizgovanje arterijskega katetra pri večini bolnikov ni potrebno. Z dokazi podprta znanja se najlažje prenašajo v prakso s pomočjo navodil za delo, dostopnih v elektronski obliki in kontrolnih list ob postelji bolnika, ki služijo za dokumentiranje, poročanje in tudi za nadaljnje raziskovanje za izboljšanje varnosti in kakovosti obravnave. Razprava in zaključek: Raziskovanje v zvezi z rokovanjem z uvedenim arterijskim katetrom v vsakodnevno prakso je potrebno. S tem se doseže izboljšanje varnosti in kakovosti zdravstveno-negovalne obravnave bolnika, osredotočanje na bolnika, pridobivanje novega znanja ter prenašanje znanja in novih dognanj v prakso.

• Language: Slovenian
• Keywords: invazivne meritve krvnega tlaka, laboratorijska analiza arterijske krvi, preprečevanje zapletov, oddelek za intenzivno zdravljenje
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2017
• PID: 20.500.12556/RUL-91831
• COBISS.SI-ID: 5257067
• Publication date in RUL: 22.04.2017

Secondary language

• Language: English
• Title: Preventing complications in a patient with inserted radial artery catheter: literature review : diploma work

Abstract

Introduction: The most frequent indications for the arterial catheter insertion are the need for frequent arterial blood gas analysis, blood laboratory tests and the expected frequent changes in the arterial blood pressure of a patient. Complications with inserted arterial catheter are many. Inaccurate results in invasive blood pressure measuring and inaccurate arterial blood laboratory findings are also often. Largely responsible in preventing complications is nursing care. Purpose: The purpose is to present the prevention of complications in patient with inserted radial arterial catheter on the theoretical level. The objectives are to demonstrate the specificities of radial arterial catheter management and to create work instructions. Methods: Descriptive method was used with the systematic review and analysis of scientific literature in English and Slovenian language. The results of the thesis was carried out from the systematic review of scientific literature. Basic literature in the English language was searched in the databases CINAHL and PubMed between 2006 and 2016. The literature in Slovenian language was searched through national bibliographic database COBIB.SI between 2006 and 2016. We also reviewed books of expert meetings for nurses. Results: Arterial catheter management without complications is the goal on the way of improving quality and safety, which in practice means using methods based on scientific evidence and undertaken by suitably qualified nurses. The recommended frequency of introduced radial arterial catheter control is at least once per shift. Inaccurate results of arterial blood laboratory analysis are blood contamination, the presence of bubbles in the tube and inaccurate handling with the tube prior to or during transport. Addition of heparin to the infusion solution is not necessary in the majority of patients. Evidence-based knowledge can be introduced into practice through work instructions, available in electronic form, and check-lists at bedside, which are used for documenting, reporting and also for further research to improve the safety and quality of nursing care. Discussion and conclusion: Research of the arterial catheter management introduced into daily practice is required. This results in improving the safety and quality of patient centred nursing care, the acquisition of new knowledge and the transfer of new knowledge into practice.

• Keywords: invasive measurements of blood pressure, the laboratorial analysis of arterial blood, disabling of complications, department of intensive care