Transition de l’héparine au sérum physiologique pour fermer les cathéters veineux centraux en oncologie : pratique fondée sur la recherche

Terri Jabaley, Niya Xiong, Susanne Conley, Teresa Mazeika, Danielle Johnson, Brenda Biggins, Nancy Hilton, Fangxin Hong

Abstract


Les patients recevant un traitement à long terme contre le cancer doivent très souvent se faire poser un cathéter veineux central (CVC). L’entretien du CVC est donc une compétence fondamentale des infirmières en oncologie. Les pratiques d’irrigation et de fermeture du CVC fondées sur la recherche aident à prévenir l’occlusion intraluminale, une complication fréquente. Les normes recommandent l’utilisation d’un soluté physiologique hépariné pour fermer le CVC; toutefois, selon la recherche, le soluté hépariné n’est pas plus efficace que le seul sérum physiologique. Les objectifs du présent projet de pratique fondée sur la recherche étaient : 1) d’évaluer si la fermeture au sérum physiologique plutôt qu’au soluté hépariné était liée à une différence significative du nombre de cas d’occlusion intraluminale chez les patients suivis en clinique d’oncologie externe; et 2) d’évaluer les effets du mentorat entre pairs sur le point de vue des infirmières et des patients quant au changement de pratique. L’analyse des données a révélé une diminution de l’utilisation d’altéplase après l’adoption du sérum physiologique pour fermer les CVC. Les sondages réalisés auprès des patients et des infirmières montrent que le mentorat entre pairs accroît la confiance des infirmières et des patients, ainsi que l’habileté à procéder au changement de pratique.


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References


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