Browse > Article
http://dx.doi.org/10.22650/JKCNR.2018.24.3.356

Effect of Evidence-Based Practice Protocol for Catheter Dysfunction in Hemodialysis Patients: Focus on Patency Rates and Bleeding Complications  

Lee, Kyung Mi (Department of Nursing, Samsung Medical Center)
Kim, Mi Yeon (Department of Nursing, Samsung Medical Center)
Publication Information
Journal of Korean Clinical Nursing Research / v.24, no.3, 2018 , pp. 356-362 More about this Journal
Abstract
Purpose: This study was a retrospective cohort study to evaluate the effect of evidence-based guidelines for catheter dysfunction among hemodialysis patients, Success rate and bleeding complications in catheterization were examined. Methods: We performed a retrospective cohort study, including 94 patients with catheter dysfunction who were receiving hemodialysis at a university hospital; 55 in the control group and 39 in the protocol group. This protocol was composed of the catheter dysfunction assessment, conservative management of catheter dysfunction, drug management of catheter dysfunction, catheter function test and maintenance management. Data were analyzed with a Chi-square test and t-test using SPSS/WIN 23.0 program. Results: The patency rate of the protocol group was significantly higher than that of the control group. The rate of bleeding complications was not statistically significant for either the control group or the protocol group before or after application. Conclusion: The application of the guidelines effectively increased the patency rate of the catheter without bleeding complications. It is hoped that this guideline can be disseminated to nurses nationwide to improve the efficiency of catheter function for hemodialysis patients.
Keywords
Bleeding; Catheter Obstruction; Patency; Renal Dialysis;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Inker LA, Astor BC, Fox CH, Isakova T, Lash JP, Peralta CA, et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD. American Journal of Kidney Diseases. 2014;63(5):713-735. https://doi.org/10.1053/j.ajkd.2014.01.416   DOI
2 The Korean Society of Nephrology. Current renal replacement therapy in Korea [Internet]. Seoul: The Korean Society of Nephrology; 2018 [cited 2018 June 1]. Available from: http://www.ksn.or.kr/rang_board/list.html?code=sinchart
3 Kim MJ, Go GY, Kim SH, Kim JY, Yun SC, Lee SW, et al. KSDA Clinical practice guideline for dialysis access Incheon: The Korean Society for Dialysis Access; 2013.
4 Kidney Dialysis Outcome Quality Initiative. Clinical practice guidelines and clinical practice recommendations, 2006 updates. New York, NY: National Kidney Foundation; 2006.
5 Kumwenda M, Mitra S, Reid C. Clinical practice guidelines: Vascular access for haemodialysis. 6th ed. Bristol: UK Renal Association; 2015.
6 Mendelssohn DC, Ethier J, Elder SJ, Saran R, Port FK, Pisoni RL. Haemodialysis vascular access problems in Canada: Results from the dialysis outcomes and practice patterns study (DOPPS II). Nephrology Dialysis Transplantation. 2006;21(3):721-728. https://doi.org/10.1093/ndt/gfi281   DOI
7 Besarab A, Pandey R. Catheter management in hemodialysis patient: Delivering adequate flow. Clinical Journal of the American Society of Nephrology. 2011;6(1):227-234. https://doi.org/10.2215/CJN.04840610   DOI
8 Ethier J, Mendelssohn DC, Elder SJ, Hasegawa T, Akizawa T, Akiba T, et al. Vascular access use and outcomes: An international perspective from the dialysis outcomes and practice patterns study. Nephrology Dialysis Transplantation. 2008;23(10):3219-3226. https://doi.org/10.1093/ndt/gfn261   DOI
9 Lee YK. Kidney disease of the month: Hemodialysis catheterrelated infection. The Korean Journal of Nephrology. 2009;28(6):708-711.
10 Mandolfo S, Acconcia P, Bucci R, Corradi B, Farina M, Rizzo MA, et al. Hemodialysis tunneled central venous catheters: Five-year outcome analysis. The Journal of Vascular Access. 2014;15(6):461-465. http://doi.org/10.5301/jva.5000236   DOI
11 Registered Nurses' Association of Ontario-Care and maintenance to reduce vascular access complications. Toronto, ON: Registered Nurses' Association of Ontario; 2008
12 Cummings-Winfield C, Mushani-Kanii T. Restoring patency to central venous access devices. Clinical Journal of Oncology Nursing. 2008;12(6):925-934. http://doi.org/10.1188/08.CJON.925-934   DOI
13 Lee KM, Kim MY, Hong JY, Cho YA, Yang WJ. Development of a practice guideline for catheter dysfunction in hemodialysis patients. Journal of Korean Clinical Nursing Research. 2016;22(2):238-247.   DOI
14 Tillett J. Evidence-based medicine, guidelines, protocols, and optimal decision making. The Journal of Perinatal & Neonatal Nursing. 2009;23(1):3-5. http://doi.org/10.1097/JPN.0b013e31819652a0   DOI
15 Shavit L, Lifschitz M, Plaksin J, Grenader T, Slotki I. High dose urokinase for restoration of patency of occluded permanent central venous catheters in hemodialysis patients. Clinical Nephrology. 2010;74(4):297-302. http:://doi.org/10.5414/cnp74297   DOI
16 Van Paesschen N, Goossens S, Tielemans C, Wissing KM. Urokinase for treatment of thrombosis-related dysfunction of tunnelled hemodialysis catheters: A single-centre retrospective comparison of 30 minute pre-dialysis thrombolysis with a prolonged lock procedure. Paper presented at: ANNA's 43rd National Symposium; 2012 April 29-May 2; Walt Disney World Dolphin. Orlando.
17 Mokrzycki MH, Lok CE. Traditional and non-traditional strategies to optimize catheter function: Go with more flow. Kidney International. 2010;78(12):1218-1231. http://doi.org/10.1038/ki.2010.332   DOI
18 Tordoir J, Canaud B, Haage P, Konner K, Basci A, Fouque D, et al. EBPG on Vascular Access. Nephrology Dialysis Transplantation. 2007;22(suppl 2):ii88- ii117. https://doi.org/10.1093/ndt/gfm021