Forde Liz, Barry Fiona
Infection Prevention and Control Nurse, Cork Community Hospitals and Public Health Nursing Services, Ireland.
School of Public Health, University College Cork, Ireland.
J Infect Prev. 2018 May;19(3):123-129. doi: 10.1177/1757177417736595. Epub 2017 Nov 23.
Indwelling urinary catheters (IUC) are reported as the most common indwelling device in hospitals and residential/care home settings.
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.
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.
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).
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.
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。
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。
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。
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)。
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。