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ÖZET Amaç: Rehberlerin önerilerine göre hazırlanan önlem ve bakım paketinin santral kateter ilişkili enfeksiyonları önlemedeki etkinliğini belirlemektir. Gereç ve Yöntem: Bir yıl boyunca yoğun bakım ünitesindeki hastalar kateter enfeksiyonu gelişimi açısından takip edildi. Rehberlere dayalı olarak oluşturulan önlem ve bakım paketi, tüm kateterlerde uygulandı. Kateterler lokal veya sistemik kan dolaşım enfeksiyonu gelişimi yönünden her gün değerlendirildi. Elde edilen veriler bir önceki yılın verileri ile karşılaştırıldı. Bulgular: Cinsiyet, yaş ve kilo farklılıklarının santral venöz kateter ilişkili enfeksiyon gelişimini etkilemediği ancak APACHE II skorları yüksek olan hastalarda daha yüksek oranda enfeksiyon geliştiği tespit edildi. Santral kateter ilişkili kan dolaşımı enfeksiyonu oranlarının ameliyathane ile yoğun bakım ünitesinde takılan kateterlerde benzer olduğu fakat dış servislerde takılan kateterlerin enfeksiyon oranlarının bu iki servisten daha yüksek olduğu belirlendi. Kateter kullanım sürelerindeki uzamanın enfeksiyon gelişimini arttırdığı ve kateterin takıldığı anatomik bölge ile ilişkili olmadığı görüldü. Bakım aşamasında kullanılan kateter örtü çeşitlerinin enfeksiyon gelişiminde etkili olmadığı belirlendi. Kateterlerden TPN, kan ve kan ürünü verilmesinin enfeksiyon gelişimini arttırdığı gözlemlendi. Sonuç: Uygulanan bakım paketleri santral venöz kateter kullanım oranlarını ve kateter ilişkili kan dolaşım enfeksiyonu sayılarını azaltmaktadır. Anah tar Ke li me ler: Bakım paketleri, santral venöz kateter enfeksiyonu, yoğun bakım ünitesi SUMMARY Objective: To detect the effects of care bundle that is prepared depending on guidelines for central line associated infections. Material and Method: Patients in a tertiary medical intensive care unit were followed up during one year period in terms of catheter infections. The care bundle that was prepared depending on guidelines was performed for all central catheter placements. Catheters were evaluated in terms of local or systemic bloodstream infections everyday. Data obtained were compared with the previous year's data. Results: We concluded that age, gender or weight characteristics have no effect on central venous catheter related infections but we detected higher infection rates at patients who had higher APACHE 2 scores. Bloodstream infection rates related with central catheter were similar between catheters inserted at operation rooms or intensive care units but catheters inserted at out services had higher infections rates. It was shown that prolonged catheter duration is related with high infection levels but anatomic place of catheter has no relationship with infection rates. No relationship was found between clothing type and infection rate. Total parenteral nutrition, blood or blood product administration via central catheter has increased infection rates. Conclusion: Performing care bundles decreases central venous catheter utilization rates central line associated bloodstream infection rates.

Background/aim: In this study, our objective was to evaluate the mortality in geriatric hip fracture patients who were operated within 48 h after admission or after the 48thh. Materials and methods: A total of 194 patients who had undergone surgery for hip fracture between 2016 and 2018 were retrospectively evaluated. Patient information was obtained from the hospital’s database using the ICD codes 81.52, 82.00–82.09, and 82.10. Radiological examination reports were collected from the patient files. Information on mortality was obtained from the Death Notification System of the Turkish Ministry of Health. First-year mortality rates of patients operated within 48 h (Group 1) and those operated at 48–96 h (Group 2) were compared.Results: The mean duration between admission to the hospital and surgical intervention was 33.90 ± 1.95 h (3–96 h). The mean total hospitalization time was 7.29 ± 1.53 days (2–36 days). Of the patients, 62 (32%) died within one year after the operation. The mean survival times for patients operated ≤48 h or >48 h were 8.47 ± 1.90 and 6.57 ± 2.59 months, respectively (Z = 1.074, P = 0.283). There was no significant correlation between survival time and the time delay before the operation (r = –0.103, P = 0.153). Additionally, the Cox regression analysis, including age (years), ASA (grade 3 vs. 2), time to operation (h), and days spent in the ICU, demonstrated no significant independent effect of the time to operation on survival (P = 0.200).Conclusion: Although shortening the time to surgery may have some rationale, we did not find any difference in patients operated before 48 h compared to 48–96 h concerning mortality.