中心靜脈導管照護及其相關感染之探討

The Exploration of Nursing Interventions and Catheter-Related Infections in Patients with Central Venous Catheters

中心靜脈導管(central venous catheters, CVC)照護是臨床常見及過程較為繁瑣的護理措施，並與感染的發生有關。目前，在國內尚無最合宜的照護標準可供遵循，且各家醫院護理人員在執行中心靜脈導管相關護理照護時，其操作步驟與預防感染處置存有差異。本文藉由搜尋實證資料庫及進行文獻回顧，探討成人中心靜脈導管置入及照護程序中常見質疑，如：皮膚消毒溶液及敷料種類的選擇、導管相關感染之實證措施，並整合文獻結果與建議，期能提供臨床護理人員於執行中心靜脈導管照護過程中的參考準則。

Central venous catheters (CVC) care is a common and complex nursing skill in clinical practice. The CVC care is associated with a risk of infection. Currently, it is not clear which standard of CVC care is the most appropriate. The procedure of sterile technique and managements for preventing infectious complications in CVC care vary among hospitals. This article explores not only the common debates regarding CVC nursing management, such as selection of cleansing agent, dressing type, the evidence-based interventions of catheter-related infections, but also integrate the results and recommendations of researches by searching evidence-based databases, and provides practice guidelines for clinical nurses in order to offer appropriate care for patients with central venous access devices.