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爱尔兰居家接受社区护理服务患者留置导尿管使用情况及适宜性的现况调查

Point prevalence survey of indwelling urinary catheter use and appropriateness in patients living at home and receiving a community nursing service in Ireland.

作者信息

Forde Liz, Barry Fiona

机构信息

Infection Prevention and Control Nurse, Cork Community Hospitals and Public Health Nursing Services, Ireland.

School of Public Health, University College Cork, Ireland.

出版信息

J Infect Prev. 2018 May;19(3):123-129. doi: 10.1177/1757177417736595. Epub 2017 Nov 23.

Abstract

BACKGROUND

Indwelling urinary catheters (IUC) are reported as the most common indwelling device in hospitals and residential/care home settings.

AIM

The aim of this study was to assess the prevalence and appropriateness of IUCs in people living at home and receiving a community nursing service.

METHODS

An IUC self-report questionnaire was sent to 66 community nurses in one community care area. A second questionnaire was completed by the researcher on each patient (n = 80) identified by the community nurses. Data were analysed using descriptive statistics and the chi-square test was used to test associations between patient demographics, catheter changes and nurses documentation.

RESULTS

The self-report questionnaire was completed by 46 of the 52 areas (88% response rate). The overall prevalence of IUCs was 1.9% with a higher prevalence among men (70%) and in the over-85-years age group (31%). The mean age was 76 years (age range = 34-98 years) and duration of use was approximately four years. Routine IUC changes were carried out by community nurses (52%), in the acute hospital (25%) or by general practitioners (20%) and the type of catheter influenced person/location of catheter changes ( = 0.001).

DISCUSSION

This study adds to the understanding of IUCs in patients at home and is the first to investigate if the IUC is appropriate in this setting. It prompted a review of current guidance and development of standard documentation for IUC management locally to ensure that the IUC in use is appropriate. It also suggests that there is a need for internationally accepted, appropriate indications for long-term IUC use to facilitate consistency and allow comparison across studies in future.

摘要

背景

据报道,留置导尿管(IUC)是医院、住宅/护理院环境中最常见的留置装置。

目的

本研究旨在评估在家中接受社区护理服务的人群中IUC的患病率及使用合理性。

方法

向一个社区护理区域的66名社区护士发放了IUC自我报告问卷。研究人员针对社区护士确定的每位患者(n = 80)填写了第二份问卷。使用描述性统计分析数据,并使用卡方检验来检验患者人口统计学、导尿管更换情况与护士记录之间的关联。

结果

52个区域中的46个区域完成了自我报告问卷(回复率88%)。IUC的总体患病率为1.9%,男性患病率较高(70%),85岁以上年龄组患病率为31%。平均年龄为76岁(年龄范围 = 34 - 98岁),使用时长约为四年。社区护士(52%)、急性医院(25%)或全科医生(20%)进行常规IUC更换,导尿管类型影响导尿管更换的人员/地点( = 0.001)。

讨论

本研究增进了对家中患者IUC情况的了解,并且是首个调查IUC在这种情况下是否合理的研究。它促使对当前指南进行审查,并在当地制定IUC管理的标准记录,以确保使用的IUC是合适的。这也表明需要国际认可的长期使用IUC的适当指征,以促进一致性,并便于未来跨研究进行比较。

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