| Abstract [eng] |
The goal of the study: to determine the role of a nurse in the maintenance of the central venous catheter (CVC) in the resuscitation and intensive care department. The objectives: to determine the influence of the central venous catheterization to the indexes of the main vital functions of the patients. To specify the most frequent venous complications and the reasons why they occur. To find out what nurses’ actions can reduce the risk of complications. To examine the professional knowledge of the nurses who work with central venous catheters in the resuscitation and intensive care departments. Research material and methods. Theoretical review of scientific literature, publications and articles. Document analysis method (utilized for the reasearch of patient’s with central venous catheters). Personal observation method. Observation of the main vital functions of 97 patients after central venous catheterization in the resuscitation and intensive care department. The questionnaire-based survey in order to examine the professional knowledge of the nurses who work with central venous catheters in the resuscitation and intensive care department. Discussion and analysis of the obtained results. Analysis of the statistical data using the Microsoft Office Excel 2003 and SPSS 16,0 for Windows software packages. The results and conclusions of the study. In order to determine the role of a nurse for the maintenance of central venous catheter, the observation research was conducted with the patients after the central venous catheterization. The research was conducted in the Resuscitation and Intensive Care Department of the Santariškės Clinic of the Vilnius University Hospital. The results obtained during the research suggested that the use of central venous catheters resulted in the deviations of arterial blood pressure; cardiac contraction frequency and breathing frequency as well as the occurrence of complications. A questionnaire-based survey was utilized in order to find out the level of nurses’ knowledge regarding the maintenance of central venous catheter it the Resuscitation and Intensive Care Department and to determine the factors which influence the nurses’ work as well as the professional experience of the nurses. The nurses of the Resuscitation and Intensive Care Department prepare the patients for the insertion of central venous catheter; take care of the central venous catheter as well as the central venous catheter insertion area. Moreover, the nurses assist the doctors during the central venous catheterization procedure; they also prepare and supply the parental nutrition blends. The research was conducted in the First Resuscitation and Intensive Care Department of the Santariškės Clinic of the Vilnius University Hospital revealed the fact that central venous catheterization affected the indexes of the patients‘ vital functions: 81.44 percent of the patients had hypotension, 11.35 percent had hypertension, about half of the patients experienced deviations of cardiac contraction frequency and breathing frequency, while 22 patients went through complications. The most common complications after the central venous catheterizations are pneumothorax and haematomas. Typically, the reason of the complications is the lack of experience of the nurse who handles the central venous catheterization and the absence of asepsis. Most of the nurses state that they participate in the complication treatment process. The analysis of the scientific literature and the research results led to the following conclusions: some of the nurses’ actions can reduce the risk of complications caused by the central venous catheterization, namely: observing the hand hygiene and hand care policy, proper preparation of the central venous catheter insertion area, proper maintenance of central venous catheters and correct and accurately maintained documentation. |
