الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The use of intravascular catheters for vascular access and hemodynamic monitoring has become a central part of modern medicine. Central venous catheters (CVCs) are widely used in critically ill patients throughout the developed world. It permits hemodynamic monitoring and allow access for the administration of fluids, blood products, medications, antibiotic therapy and total parenteral nutrition (TPN). In addition, it is indicated in the case of poor peripheral access and provides reliable access for hydration or electrolyte maintenance. Although CVCs have significant benefits in many clinical situations, the increase in their use over the last 20 years has been associated with at least a doubling of resultant nosocomial infections.
The use of intravascular catheters for vascular access and hemodynamic monitoring has become a central part of modern medicine. Central venous catheters (CVCs) are widely used in critically ill patients throughout the developed world. It permits hemodynamic monitoring and allow access for the administration of fluids, blood products, medications, antibiotic therapy and total parenteral nutrition (TPN). In addition, it is indicated in the case of poor peripheral access and provides reliable access for hydration or electrolyte maintenance. Although CVCs have significant benefits in many clinical situations, the increase in their use over the last 20 years has been associated with at least a doubling of resultant nosocomial infections.
Catheter- related infection (CRI) remains a leading cause of nosocomial infections, especially in intensive care units and is associated with significant patient morbidity, mortality, increased duration of hospitalization, and additional medical costs. There are four potential sources for CRI: the skin insertion site, the catheter hub, hematogenous seeding from a distant infection and contaminated infusate. The skin insertion site and the catheter hub are by far the two most important sources. Approximately 65% of CRI originate from the skin flora. Although a common problem, the descriptive epidemiology, pathophysiology, risk factors and best means of diagnosing CRI have not yet been fully elucidated.
Critical care nurse has an important role in maintaining an infusion protection of the patients from hazard and complications associated with routine central venous catheter care. Her role expands from catheter insertion until catheter removal. Methods and techniques used during maintenance of CVC by nurses are critically important in preventing catheter related infection. Dressing of CVC is very important as it provide protection of the catheter insertion site from external contamination, absorb bleeding, secure the catheter and discourage bacterial proliferation. Frequency of CVC dressing is not standardized; it can vary from daily to weekly.