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大型社区医院减少导尿管相关创伤的质量改进导尿管项目

Quality Improvement Foley Project to Reduce Catheter-Related Trauma in a Large Community Hospital.

作者信息

Dave Chirag, Faraj Kassem, Vakharia Paras, Boura Judy, Hollander Jay

出版信息

J Healthc Qual. 2018 Jan/Feb;40(1):51-57. doi: 10.1097/JHQ.0000000000000108.

Abstract

Indwelling catheter placement is a modifiable risk factor for urethral trauma. We implemented a multidisciplinary Foley Project protocol in June 2015, which consisted of a system-wide catheter education program, difficult urinary catheterization (DUC) algorithm, and skilled catheter nursing team to improve patient outcomes. A retrospective review of male DUC consults between June 2014 and September 2015 was performed. The preprotocol group includes consults received from June 2014 to May 2015. The postprotocol group includes consults received from June 2015 to September 2015. There were 74 patients in the preprotocol and 18 patients in the postprotocol group. The overall incidence rates of catheter-associated trauma during placement were 41.1% in the preprotocol and 5.9% in the postprotocol groups (p = .005). In the preprotocol group, 53.4% required a procedure by a urologist, whereas only 11.8% of patients in the postprotocol group required a procedure (p = .002). The Foley Project protocol reduced the frequency of catheter-associated trauma and procedures.

摘要

留置导尿管是尿道创伤的一个可改变的危险因素。我们于2015年6月实施了一项多学科福勒项目方案,该方案包括全系统的导尿管教育计划、困难导尿(DUC)算法以及专业的导尿管护理团队,以改善患者预后。对2014年6月至2015年9月期间男性DUC会诊进行了回顾性研究。方案实施前组包括2014年6月至2015年5月期间收到的会诊。方案实施后组包括2015年6月至2015年9月期间收到的会诊。方案实施前组有74例患者,方案实施后组有18例患者。置管期间导管相关创伤的总体发生率在方案实施前组为41.1%,在方案实施后组为5.9%(p = .005)。在方案实施前组,53.4%的患者需要泌尿外科医生进行手术,而在方案实施后组,只有11.8%的患者需要手术(p = .002)。福勒项目方案降低了导管相关创伤和手术的发生率。

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