Nazarko Linda
Ealing PCT.
Br J Nurs. 2008;17(16):1002, 1004, 1006 passim.
Primum non nocere (first do no harm) is the ancient Latin phrase that reminds nurses that first principle of healthcare is not to harm those entrusted to our care. Yet, common healthcare interventions, such as urinary catheterization, have the potential to do patients great harm. The patient may even pay with his or her life if a urinary catheter is inserted without clinical indications or if the nurse fails to do his or her utmost to protect the patient from infection. Urinary tract infection (UTI) is the most common of healthcare-related infection. UTI in hospital inpatients normally occurs in people who have a urinary catheter inserted. Urinary catheterization is common and although the risks of catheter-associated UTI are small, the consequences or catheter-associated UTI can be life threatening. Urinary catheterization increases morbidity by a factor of three. Restricting catheterization to those who clinically require this invasive procedure can reduce the number of people who developed infection and life threatening bacteraemia. The use of silver-coated catheters can reduce the risks of infection. Evidence based practice can further reduce risks of catheterization. It is important that informed consent is obtained prior to catheterization. If a person lacks capacity the clinician must act in the person's best interests.
“首要之务，勿伤患者”是一句古老的拉丁短语，它提醒护士医疗保健的首要原则是不伤害托付给我们照顾的人。然而，常见的医疗保健干预措施，如导尿术，有可能对患者造成极大伤害。如果在没有临床指征的情况下插入导尿管，或者护士未能尽最大努力保护患者免受感染，患者甚至可能付出生命代价。尿路感染（UTI）是最常见的与医疗保健相关的感染。医院住院患者的UTI通常发生在插入导尿管的人群中。导尿术很常见，虽然导尿管相关UTI的风险很小，但导尿管相关UTI的后果可能危及生命。导尿术会使发病率增加三倍。将导尿术限制在临床上需要这种侵入性操作的人身上，可以减少发生感染和危及生命的菌血症的人数。使用镀银导尿管可以降低感染风险。循证实践可以进一步降低导尿风险。在导尿术前获得知情同意很重要。如果一个人没有行为能力，临床医生必须以该人的最大利益行事。
