Wang Pey-Tsung, Lin Hsiang-Yu, Lin Yi-Tsun, Shin Wen-Huey, Chien Li-Yin, Lin Shirling
Department of Nursing, Taipei Veterans General Hospital, Taiwan, ROC.
Institute of Community Health Care, National Yang-Ming University, Taiwan, ROC.
Hu Li Za Zhi. 2017 Feb;64(1):70-79. doi: 10.6224/JN.64.1.70.
Urinary tract infections are a common iatrogenic infection in healthcare institutions. Catheter-associated urinary tract infections (CAUTIs) may result in sepsis, prolonged hospitalization, additional hospital costs, and mortality.
The study examined the efficacy of an indicator-based reminder of catheter removal in decreasing CAUTIs among patients in the general medical ward.
A two-group, quasi-experimental design was used. The intervention strategies included daily implementation of the indicator-based reminder procedure and standardized Foley care and a teaching program for all staff nurses. All patients who received Foley during hospitalization were included, with the exception of those with CAUTI at admission. Seventy-five patients were enrolled from five wards in a medical center, with 33 assigned to the control group and 42 assigned to the experimental group.
CAUTIs were diagnosed in 7 participants (16.7%) in the experimental group and 15 participants (45.5%) in the control group. The differences were statistically significant (p = .014). The mean number of Foley days was 14.73% less in the experimental group, with 11.0 for the experimental group and 12.9 for the control group. The incidence density of CAUTIs was 15.2% for the experimental group and 35.3% for the control group.
The present study supports that an indicator-based reminder of catheter removal decreases the incidence rate and incidence density of CAUTIs. Medical personnel in the general medical ward may use this reminder to detect unnecessary indwelling of urinary catheters and to remove Foley catheters as early as feasible in order to prevent CAUTIs.
尿路感染是医疗机构中常见的医源性感染。导尿管相关尿路感染（CAUTIs）可能导致败血症、住院时间延长、额外的住院费用和死亡率。
本研究探讨基于指标的导尿管拔除提醒在降低普通内科病房患者CAUTIs发生率方面的效果。
采用两组准实验设计。干预策略包括每日实施基于指标的提醒程序、标准化的Foley导尿管护理以及针对所有护士的教学计划。纳入所有住院期间接受Foley导尿管的患者，但入院时患有CAUTIs的患者除外。从一家医疗中心的五个病房招募了75名患者，其中33名分配到对照组，42名分配到实验组。
实验组有7名参与者（16.7%）被诊断为CAUTIs，对照组有15名参与者（45.5%）。差异具有统计学意义（p = .014）。实验组Foley导尿管留置天数的平均值减少了14.73%，实验组为11.0天，对照组为12.9天。实验组CAUTIs的发病密度为15.2%，对照组为35.3%。
本研究支持基于指标的导尿管拔除提醒可降低CAUTIs的发生率和发病密度。普通内科病房的医务人员可利用此提醒来检测不必要的导尿管留置，并尽早拔除Foley导尿管以预防CAUTIs。
