Turkiye Klinikleri Journal of Nursing Sciences

.: ORIGINAL RESEARCH
Periferik Venöz Kateter Kaynaklı Flebit Gelişme Durumu ve Hemşirelerin Kanıta Dayalı Uygulamalara İlişkin Bilgi Düzeyleri: Nokta Prevalans Çalışması
Phlebitis Associated with Peripheric Venous Catheter Development and Knowledge of Nurses on Evidence- Based Practices: Point Prevalence Study
Betül TOSUNa, Betül KILIÇ ARSLANb, Nurten ÖZENc
aHasan Kalyoncu Üniversitesi Sağlık Bilimleri Fakültesi, Hemşirelik Bölümü, Gaziantep, TÜRKİYE
bGülhane Eğitim ve Araştırma Hastanesi, Ankara, TÜRKİYE
cDemiroğlu Bilim Üniversitesi İstanbul Florence Nightingale Hastanesi, Hemşirelik Yüksekokulu, İstanbul, TÜRKİYE
Turkiye Klinikleri J Nurs Sci. 2020;12(1):72-82
doi: 10.5336/nurses.2019-70847
Article Language: TR
Full Text
ÖZET
Amaç: Cerrahi kliniklerde flebit prevalansını, etkileyen faktörleri ve hemşirelerin periferik venöz kateter (PVK) ilişkili enfeksiyonların önlenmesi konusunda kanıta dayalı uygulamalara ilişkin bilgi düzeylerini belirlemektir. Gereç ve Yöntemler: Prospektif gözlemsel ve tanımlayıcı tipte tek günlük nokta prevalans çalışması, Ocak-Mart 2019 tarihleri arasında bir eğitim ve araştırma hastanesinin yetişkin cerrahi servislerinde yatarak tedavi gören 103 hasta ve bu birimlerde çalışan 159 hemşire ile yürütüldü. Verilerin toplanmasında katılımcıların tanıtıcı özelliklerine ilişkin soru formu, PVK ilişkili flebit değerlendirme formu, flebit tanılama skalası ile PVK ilişkili enfeksiyonları önlemeye yönelik soru formu kullanıldı. Bulgular: Hastaların yaş ortalaması 51,17±19,60 yıl ve %59,2'si (n=61) erkektir. Hastaların %24,3'ünde (n=25) flebit semptomları geliştiği saptandı. İntravenöz antibiyotik tedavisi alan (p=0,003), total parenteral beslenme solüsyonu verilen (p=0,001), aynı damara girişim sıklığı birden fazla olan (p=0,027) hastalarda flebit semptomları görülme sıklığı daha fazlaydı. Yaş ortalaması yüksek olan hastalarda (p=0,023) ve kateter takılma süresi ortalaması daha uzun olanlarda (p=0,001) daha fazla flebit görüldü. Hemşirelerin yaş ortalaması 38,21±17,69 yıl ve çoğunluğu (%71,7, n=114) lisans mezunudur. Hemşirelerin PVK ilişkili enfeksiyonları önlemeye yönelik soru formu puan ortalaması 4,51±1,67 olarak saptandı. Sonuç: Cerrahi kliniklerde tedavi gören PVK olan hastaların dörtte birinde flebit semptomları geliştiği, hemşirelerin PVK ilişkili enfeksiyonların önlenmesinde kanıta dayalı uygulamalar konusunda bilgi düzeylerinin düşük olduğu saptandı.

Anahtar Kelimeler: Periferik venöz kateter; flebit; kanıta dayalı uygulamalar; hemşirelik
ABSTRACT
Objective: To determine the phlebitis prevalence and affecting factors and the knowledge of nurses on evidence-based practices related to avoiding peripheric venous catheter (PVC) associated infections in surgical clinics. Material and Methods: This cross-sectional prospective observational point prevalence study was conducted in adult surgical wards of a training and research hospital, in June-March 2019. The sample consisted of 103 patients with peripheric venous catheter and 159 nurses working in surgical clinics. The data was collected by 'Phlebitis Scale', 'Questionnaire for Avoiding Infections Associated with PVC' and data collection forms developed by researchers. Results: Mean age of patients was 51.17±19.60 years and 59.2% (n=61) were male. Phlebitis associated with peripheric venous catheter prevalence was 24.3% (n=25). Phlebitis frequency was higher in patients who were given intravenous antibiotics (p=0.003), who were given total parenteral nutrition solution (p=0.001), who had multiple interventions on the same vein (p=0.027). Phlebitis frequency was higher in patients with higher mean age (p=0.023) and patients who had longer mean catheterization time (p=0.001). Mean age of nurses was 38.21±17.69 years and the majority of them (71.7%, n=114) had bachelor's degree. In assessment of knowledge of nurses on avoiding phlebitis, mean correct answer was 4.51±1.67 over 10 questions. Conclusion: It is found that in the surgical clinics one fourth of patients with PVC had phlebitis symptoms associated with PVC and the knowledge of nurses on evidence-based practices for avoiding PVC associated infections was not at desired levels.

Keywords: Peripheric venous catheter; phlebitis; evidence-based practices; nursing
REFERENCES:
  1. Fernández-Ruiz M, Carretero A, Díaz D, Fuentes C, González JI, García-Reyne A, et al. Hospital-wide survey of the adequacy in the number of vascular catheters and catheter lumens. J Hosp Med. 2014;9(1):35-41. [Crossref]  [PubMed] 
  2. Chopra V, Flanders SA, Saint S, Woller SC, O'Grady NP, Safdar N, et al. The Michigan Appropriateness Guide for Intravenous Catheters (MAGIC): results from a multispecialty panel using the RAND/UCLA appropriateness method. Ann Intern Med. 2015;163(6 Suppl):S1-40. [Crossref]  [PubMed] 
  3. Sabri A, Szalas J, Holmes KS, Labib L, Mussivand T. Failed attempts and improvement strategies in peripheral intravenous catheterization. Biomed Mater Eng. 2012;23(1-2):93-108. [Crossref]  [PubMed] 
  4. Webster J, Osborne S, Rickard CM, New K. Clinically-indicated replacement versus routine replacement of peripheral venous catheters. Cochrane Database Syst Rev. 2015;14(8):CD007798. [Crossref] 
  5. González López JL, Arribi Vilela A, Fernández del Palacio E, Olivares Corral J, Benedicto Marti, Herrera Portal P. Indwell times, complications and costs of open vs closed safety peripheral intravenous catheters: a randomized study. J Hosp Infect. 2014;86(2):117-26. [Crossref]  [PubMed] 
  6. Urbanetto Jde S, Peixoto CG, May TA. Incidence of phlebitis associated with the use of peripheral IV catheter and following catheter removal. Rev Lat Am Enfermagem. 2016;24:e2746. [Crossref]  [PubMed]  [PMC] 
  7. Infusion Nurses Society. Infusion nursing standards of practice. J Infus Nurs. 2006;29(1 Suppl):S1-92. [Crossref]  [PubMed] 
  8. Chiu PC, Lee YH, Hsu HT, Feng YT, Lu IC, Chiu SL, et al. Establish a perioperative check forum for peripheral intravenous access to prevent the occurrence of phlebitis. Kaohsiung J Med Sci. 2015;31(4):215-21. [Crossref]  [PubMed] 
  9. Alexandrou E, Ray-Barruel G, Carr PJ, Frost SA, Inwood S, Higgins N, et al. Use of short peripheral intravenous catheters: characteristics, management, and outcomes worldwide. J Hosp Med. 2018;13(5):E1-7. [Crossref]  [PubMed] 
  10. Uslusoy E, Mete S. Predisposing factors to phlebitis in patients with peripheral intravenous catheters: a descriptive study. J Am Acad Nurse Pract. 2008;20(4):172-80. [Crossref]  [PubMed] 
  11. Rickard CM, McCann D, Munnings J, McGrail MR. Routine resite of peripheral intravenous devices every 3 days did not reduce complications compared with clinically indicated resite: a randomised controlled trial. BMC Med. 2010;8:53. [Crossref]  [PubMed]  [PMC] 
  12. Boyce BA, Yee BH. Incidence and severity of phlebitis in patients receiving peripherally infused amiodarone. Crit Care Nurse. 2012;32(4):27-34. [Crossref]  [PubMed] 
  13. Milutinović D, Simin D, Zec D. Risk factor for phlebitis: a questionnaire study of nurses' perception. Rev Lat Am Enfermagem. 2015;23(4):677-84. [Crossref]  [PubMed]  [PMC] 
  14. Gallant P, Schultz AA. Evaluation of a visual ınfusion scale for determining appropriate discontinuation of peripheral intravenous catheters. J Infus Nurs. 2006;29(6):338-45. [Crossref]  [PubMed] 
  15. Cicolini G, Simonetti V, Comparcini D, Labeau S, Blot S, Pelusi G, et al. Nurses' knowledge of evidence-based guidelines on the prevention of peripheral venous catheter-related infections: a multicentre survey. J Clin Nurs. 2014;23(17-18):2578-88. [Crossref]  [PubMed] 
  16. Hossain A, Arif IA, Haque M. Assessment of the level of knowledge and practice on intravenous cannulization among staff nurses of selected tertiary care hospital in Dhaka city. MOJ Public Health. 2016;4(5):156-9. [Crossref] 
  17. Hadaway L. Short peripheral intravenous catheters and infections. J Infus Nurs. 2012;35(4):230-40. [Crossref]  [PubMed]  [PMC]  [Crossref]  [PubMed] 
  18. Gorski LA, Hadaway L, Hagle M, McGoldrick M, Orr M, Doellman D. Infusion therapy standards of practice. J Infus Nurs. 2016; 39(Suppl 1):S1-159.
  19. Boyd S, Aggarwal I, Davey P, Logan M, Nathwani D. Peripheral intravenous catheters: the road to quality improvement and safer patient care. J Hosp Infect. 2011;77(1):37-41. [Crossref]  [PubMed] 
  20. DeVries M, Valentine M, Mancos P. Protected clinical indication of peripheral intravenous lines: Successful implementation. J Assoc Vasc Access. 2016;21(2):89-92. [Crossref] 
  21. Fitzgerald C, Kantrowitz-Gordon I, Katz J, Hirsch A. Advanced practice nursing education: challenges and strategies. Nurs Res Pract. 2012;2012:854918. [Crossref]  [PubMed]  [PMC] 
  22. Ferrete-Morales C, Vázquez-Pérez MA, Sánchez-Berna M, Gilabert-Cerro I, Corzo-Delgado JE, Pineda-Vergara JA, et al. [Incidence of phlebitis due to peripherally inserted venous catheters: impact of a catheter management protocol]. Enferm Clin. 2010;20(1):3-9. [Crossref]  [PubMed] 
  23. Erdoğan BC, Denat Y. [Peripheral intravenous catheter infiltration and nursing care]. J Hum Rhythm. 2016;2(1):6-12.
  24. Arpa Y, Cengiz A. [Determining of the knowledge levels of healthcare staff in the diagnosis and prevention of development of phlebitis and thrombophlebitis associated with intravenous infusion therapy]. Hemşirelikte Eğitim ve Araştırma Dergisi. 2016;13(1):21-6.
  25. Sarı D, Eşer İ, Akbıyık A. Phlebitis associated with peripheral intravenous catheters and nursing care. Journal of Human Sciences. 2016;13(2):2905-20. [Crossref] 
  26. Kuş B, Büyükyılmaz F. [Current evidence for prevention of the complications related to peripheral intravenous catheterization: systematic review]. FNJN. 2017;25(3):209-17.
  27. Mattox EA. Complications of peripheral venous access devices: prevention, detection, and recovery strategies. Crit Care Nurse. 2017;37(2):e1-14. [Crossref]  [PubMed]  [PMC]  [Crossref]  [PubMed] 
  28. Atay S, Sen S, Cukurlu D. Phlebitis-related peripheral venous catheterization and the associated risk factors. Niger J Clin Pract. 2018;21(7):827-31.
  29. Pasalioglu KB, Kaya H. Catheter indwell time and phlebitis development during peripheral intravenous catheter administration. Pak J Med Sci. 2014;30(4):725-30. [Crossref]  [PubMed]  [PMC] 
  30. Palese A, Ambrosi E, Fabris F, Guarnier A, Barelli P, Allegrini E, et al. Nursing care as a predictor of phlebitis related to insertion of a peripheral venous cannula inemergency departments: findings from a prospective study. J Hosp Infect. 2016;92(3):280-6. [Crossref]  [PubMed] 
  31. O'Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, et al. Guidelines for the prevention of intravascular catheter-related infections. Am J Infect Control. 2011;39(4 Suppl 1):S1-34. [Crossref]  [PubMed] 
  32. Nyika ML, Mukona D, Zvinavashe M. Factors contributing to phlebitis among adult patients admitted in the medical-surgical units of a central hospital in harare, Zimbabwe. J Infus Nurs. 2018;41(2):96-102. [Crossref]  [PubMed] 
  33. Abbas SZ, de Vries TK, Shaw S, Abbas SQ. Use and complications of peripheral vascular catheters: a prospective study. Br J Nurs. 2007;16(11):648, 650, 652. [Crossref]  [PubMed] 
  34. Rego Furtado LC. Incidence and predisposing factors of phlebitis in a surgery department. Br J Nurs. 2011;20(14):S16-8, S20, S22 passim. [Crossref]  [PubMed] 
  35. Salgueiro-Oliveira A, Veiga P, Parreira P. Incidence of phlebitis in patients with peripheral intravenous catheters: the influence of some risk factors. Aust J Adv Nurs. 2015;30(2):32-9.
  36. Kaur P, Thakur R, Kaur S, Bhalla A. Assessment of risk factors of phlebitis amongst intravenous cannulated patients. Iran J Nurs Midwifery Res. 2011;7(3):106-14.
  37. Lanbeck P, Odenholt I, Paulsen O. Antibiotics differ in their tendency to cause infusion phlebitis: a prospective observational study. Scand J Infec Dis. 2002;34(7):512-9. [Crossref]  [PubMed] 
  38. Lanbeck P, Odenholt I, Paulsen O. Dicloxacillin: a higher risk than cloxacillin for infusion phlebitis. Scand J Infec Dis. 2003;35(6-7):397-400. [Crossref]  [PubMed] 
  39. Simin D, Milutinović D, Turkulov V, Brkić S. Incidence, severity and risk factors of peripheral intravenous cannula-induced complications: an observational prospective study. J Clin Nurs. 2019;28(9-10):1585-99. [Crossref]  [PubMed] 
  40. Enes SM, Opitz SP, Faro AR, Pedreira Mde L. Phlebitis associated with peripheral intravenous catheters in adults admitted to hospital in the Western Brazilian Amazon. Rev Esc Enferm USP. 2016;50(2):263-71. [Crossref]  [PubMed] 
  41. Chang WP, Peng YX. Occurrence of phlebitis: a systematic review and meta-analysis. Nurs Res. 2018;67(3):252-60. [Crossref]  [PubMed] 
  42. Chalmers C, Straub M. Standard principles for preventing and controlling infection. Nurs Stand. 2006;20(23):57-65. [Crossref]  [PubMed] 
  43. Wallis MC, McGrail M, Webster J, Marsh N, Gowardman J, Playford EG, et al. Risk factors for peripheral ıntravenous catheter failure: a multivariate analysis of data from a randomized controlled trial. Inf Cont Hosp Epidem. 2014;35(1):63-8. [Crossref]  [PubMed] 
  44. Webster J, Osborne S, Rickard CM, Marsh N. Clinically-indicated replacement versus routine replacement of peripheral venous catheters. Cochrane Database Syst Rev. 2019;1:CD007798. [Crossref]  [PMC] 

.: Up To Date

Login



Contact


Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com