Columbia University School of Nursing, Columbia University, New York, NY 10032, USA.
Am J Infect Control. 2012 Oct;40(8):705-10. doi: 10.1016/j.ajic.2011.09.020. Epub 2012 Feb 7.
Little is known about whether recommended strategies to prevent catheter-associated urinary tract infection (CAUTI) are being implemented in intensive care units (ICU) in the United States.
Our objectives were to describe the presence of and adherence to CAUTI prevention policies in ICUs, to identify variations in policies based on organizational characteristics, and to determine whether a relationship exists between prevention policies and CAUTI incidence rates.
Four hundred forty-one hospitals that participate in the National Healthcare Safety Network were surveyed in spring 2008.
Two hundred fifty hospitals provided information for 415 ICUs (response rate, 57%). A small proportion of ICUs surveyed had policies supporting bladder ultrasound (26%, n = 106), condom catheters (20%, n = 82), catheter removal reminders (12%, n = 51), or nurse-initiated catheter discontinuation (10%, n = 39). ICUs in hospitals with ≥ 500 beds were half as likely as those in smaller hospitals to have adopted at least 1 CAUTI prevention policy (odds ratio, 0.52; 95% confidence interval: 0.33-0.86), and ICUs in hospitals where the infection control director reported always having access to key decision makers for planning were more than twice as likely as those with less access to have adopted a policy (odds ratio, 2.41; 95% confidence interval: 1.56-3.72).
Little attention is currently placed on CAUTI prevention in ICUs in the United States. Further research is needed to elucidate relationships between adherence to CAUTI prevention recommendations and CAUTI incidence rates.
在美国，重症监护病房（ICU）中是否实施了预防导管相关尿路感染（CAUTI）的推荐策略，目前知之甚少。
我们的目的是描述 ICU 中 CAUTI 预防政策的存在情况和实施情况，根据组织特征识别政策的差异，并确定预防政策与 CAUTI 发生率之间是否存在关系。
2008 年春季，对参加国家医疗保健安全网络的 441 家医院进行了调查。
250 家医院为 415 个 ICU 提供了信息（应答率为 57%）。接受调查的 ICU 中，只有一小部分制定了支持膀胱超声（26%，n=106）、 condom 导尿管（20%，n=82）、导管拔除提醒（12%，n=51）或护士启动导管拔除（10%，n=39）的政策。床位≥500 张的医院中的 ICU 采用至少 1 项 CAUTI 预防政策的可能性是床位较少医院的一半（比值比，0.52；95%置信区间：0.33-0.86），感染控制主任报告始终能够获得关键决策者以进行规划的医院中的 ICU 采用预防政策的可能性是获得较少决策者支持的 ICU 的两倍多（比值比，2.41；95%置信区间：1.56-3.72）。
目前美国 ICU 对 CAUTI 预防的重视程度较低。需要进一步研究阐明遵守 CAUTI 预防建议与 CAUTI 发生率之间的关系。
