Establishment of an External Ventricular Drain Best Practice Guideline: The Quest for a Comprehensive, Universal Standard for External Ventricular Drain Care
| Autor: | Barry M. Czeisler, Marina Spektor, Millie Hepburn-Smith, Aaron Lord, Irina Dynkevich, Ariane Lewis |
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| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
MEDLINE CINAHL Asepsis Ventriculostomy 03 medical and health sciences 0302 clinical medicine Catheters Indwelling Nursing Medicine Humans 030212 general & internal medicine Intensive care medicine Device Removal Nursing literature Infection Control Catheter insertion Endocrine and Autonomic Systems business.industry Guideline Medical–Surgical Nursing Catheter Practice Guidelines as Topic Drainage Surgery Neurology (clinical) business 030217 neurology & neurosurgery External ventricular drain Hydrocephalus |
| Zdroj: | The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses. 48(1) |
| ISSN: | 1945-2810 |
| Popis: | External ventricular drains (EVDs) are commonly used to facilitate removal of cerebrospinal fluid in patients with neurologic dysfunction. Despite a high risk for infection (upward of 45%), many hospitals lack strict protocols for EVD placement and maintenance. In addition, EVD infections are typically not tracked with the same diligence as central-line catheter infections, because there are no widely accepted standards for routine management of EVDs. The purpose of this review is to provide a guide for the development of a standardized, best practice EVD protocol for catheter insertion, care, and maintenance to reduce ventriculostomy-related infections. A secondary goal of this review is to provide support for the future development of guidelines for the consistent tracking of EVD insertion and maintenance practices.At an academic medical center, an interdisciplinary team of nurses, advanced practice nurses, and neurointensivists reviewed recent medical and nursing literature as well as research-based institutional protocols on EVD insertion and maintenance from the United States and abroad to determine global best practices. The goal of this literature review was to identify key areas of focus in EVD insertion and maintenance as well as to identify recent studies that have shown success in managing EVDs with low rates of infection. The following terms were used in this search: EVD, externalized ventricular drains, EVD infections, EVD insertion, EVD Care and Maintenance, Nursing and EVDS. The following databases were utilized by each member of the interdisciplinary team to establish a state of the science on EVD management: American Association of Neurosurgical Surgeons, CINAHL, Cochrane, National Guidelines Clearinghouse, and PubMed. The following common EVD themes were identified: preinsertion hair removal and skin preparation, aseptic technique, catheter selection, monitoring of EVD insertion technique using a "bundle" approach, postinsertion dressing type and frequency of dressing changes, techniques for maintenance and cerebrospinal fluid sampling, duration of catheter placement, staff education/competence, and surveillance. |
| Databáze: | OpenAIRE |
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