Wilde Mary H, Carrigan Mary Jo
School of Nursing, College of Human Services and Health Professions, Syracuse University, Syracuse, New York, USA.
J Adv Nurs. 2003 Aug;43(3):254-62. doi: 10.1046/j.1365-2648.2003.02708.x.
Clients with long-term urinary catheters are at risk for urinary tract infection (UTI) and catheter blockage that disrupt client/family daily activities. The United States Centers for Disease Control guideline strongly recommends keeping urine flowing to help prevent UTI in this population, but little is known about factors associated with urine flow and how they are related to UTI.
The purpose of this descriptive study was to identify urine flow factors contributing to UTI in home care clients who had had an indwelling urinary catheter for at least 3 months.
Twenty-four records were reviewed from one home care agency. The sample of 12 males and 12 females ranged in age from 31-102 (mean 70 years, sd 17.2) and they had used a catheter from 5 to 105 months (mean 27.9, sd 32).
Catheter blockage and low urine output were the only 'urine flow indicators' that were significantly related to UTI. Other 'urine flow indicators' were not related to UTI, including bloodstained urine, pulling on the catheter, leakage, and sluggish urine. Thirteen people experienced blockage and 11 did not. Of the 13 with blockage, six had UTI and seven did not, during the 6 months of the review. It was particularly notable that, of the 11 people with no blockage, none went on to experience UTI.
This finding raises questions about why some people with blockage developed UTI and some did not. We suggest that nurses taught their clients what to do to get the urine flowing, such as, increasing fluid intake or checking for proper placement. Identifying more information from clients about how they monitor and adjust urine flow will be the next step toward understanding how to prevent UTI in those with long-term catheters.
长期使用导尿管的患者有发生尿路感染（UTI）和导尿管堵塞的风险，这会干扰患者及其家人的日常活动。美国疾病控制中心指南强烈建议保持尿液通畅，以帮助预防该人群发生UTI，但对于与尿液流动相关的因素以及它们与UTI的关系知之甚少。
这项描述性研究的目的是确定在留置导尿管至少3个月的家庭护理患者中导致UTI的尿液流动因素。
回顾了一家家庭护理机构的24份记录。样本包括12名男性和12名女性，年龄在31至102岁之间（平均70岁，标准差17.2），他们使用导尿管的时间为5至105个月（平均27.9个月，标准差32）。
导尿管堵塞和尿量少是仅有的与UTI显著相关的“尿液流动指标”。其他“尿液流动指标”与UTI无关，包括血尿、拉扯导尿管、漏尿和尿流缓慢。13人发生堵塞，11人未发生堵塞。在审查的6个月期间，13名发生堵塞的患者中，6人发生UTI，7人未发生。特别值得注意的是，11名未发生堵塞的患者中，没有一人随后发生UTI。
这一发现引发了关于为什么一些发生堵塞的人会发生UTI而另一些人没有的疑问。我们建议护士教导患者如何使尿液通畅，例如增加液体摄入量或检查导尿管放置是否正确。从患者那里获取更多关于他们如何监测和调整尿液流动的信息将是朝着了解如何预防长期使用导尿管患者发生UTI迈出的下一步。
