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[一项旨在改善留置导尿管使用并减少尿路感染的干预措施的影响]

[Impact of an intervention to improve indwelling urinary catheter use and reduce urinary tract infections].

作者信息

Smithson A, Bosch L, Ramos X, Martínez-Santana V

机构信息

Unidad de Infecciones, Fundació Hospital de l'Esperit Sant, Santa Coloma de Gramenet, Barcelona, España.

Enfermería, Fundació Hospital de l'Esperit Sant, Santa Coloma de Gramenet, Barcelona, España.

出版信息

Rev Calid Asist. 2016 Jul-Aug;31(4):227-33. doi: 10.1016/j.cali.2015.10.005. Epub 2015 Dec 23.

Abstract

OBJECTIVE

To evaluate the impact of an intervention regarding the adequate use and improvement in the care of indwelling urinary catheters (IUC) and the frequency of catheter-associated urinary tract infections (CAUTI) in hospitalised patients.

MATERIAL AND METHODS

A quasi-experimental study was performed. Basic data on the use of IUC were recorded before and after the intervention, which consisted of training on IUC use and the implementation of reminders for their removal.

RESULTS

There were 197 patients in the pre-intervention period and 194 in the post-intervention period. There was a non-significant decrease in the prevalence (17.3% versus 15.3%) and days with IUC (4.8±5.8 versus 4.3±4.2). There was an increase in adequately prescribed (41.1% versus 61.9%; P<.001) and attached IUC (0% vs 38.1%; P<.001), and a decrease in the urine collection bags on the floor (26.4% vs 6,2%; P<.001). The increase in the appropriate indications for IUC (86.8% vs 92.3%) and the decrease in CAUTI incidence density (2.1 vs 1.2 episodes/1,000 catheter days) were not significant, although above the standards.

CONCLUSIONS

After the intervention there was a significant increase in the number of adequately prescribed and attached IUC, and a decrease in the number of urine collection bags on the floor. Improvement in IUC indication and frequency of CAUTI reached the quality standards. Educational activities and the use of reminders improve safety of hospitalised patients with IUC.

摘要

目的

评估一项关于留置导尿管(IUC)合理使用及护理改善的干预措施对住院患者导尿管相关尿路感染(CAUTI)发生率的影响。

材料与方法

进行了一项准实验研究。在干预前后记录IUC使用的基础数据,干预措施包括IUC使用培训及实施移除提醒。

结果

干预前期有197例患者,干预后期有194例患者。IUC的患病率(17.3%对15.3%)和使用天数(4.8±5.8对4.3±4.2)有非显著性下降。合理开具(41.1%对61.9%;P<0.001)和留置IUC(0%对38.1%;P<0.001)的情况有所增加,地上尿袋数量减少(26.4%对6.2%;P<0.001)。IUC合理适应证的增加(86.8%对92.3%)和CAUTI发病密度的降低(2.1对1.2例/1000导尿管日)虽高于标准但无显著性差异。

结论

干预后,合理开具和留置IUC的数量显著增加,地上尿袋数量减少。IUC适应证及CAUTI发生率的改善达到了质量标准。教育活动及提醒的使用提高了留置IUC住院患者的安全性。

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