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降低留置导尿管出院的泌尿外科肿瘤患者的导管相关性尿路感染:一项质量改进项目。

Decreasing Catheter-Associated Urinary Tract Infections in Urologic Oncology Patients Discharged With an Indwelling Urinary Catheter: A Quality Improvement Project.

作者信息

Spencer Tammy S, Flynn Makic Mary Beth, Shaw Kathy

出版信息

J Perianesth Nurs. 2019 Apr;34(2):394-402. doi: 10.1016/j.jopan.2018.07.002. Epub 2018 Oct 15.

Abstract

PURPOSE

Few strategies exist regarding decreasing catheter-associated urinary tract infections (CAUTIs) in the outpatient urologic oncology population discharged with an indwelling urinary catheter (IUC).

DESIGN

A quality improvement methodology using a premeasurement-postmeasurement structure was used to study the impact of process interventions on reducing CAUTIs.

METHODS

Creation of IUC outpatient materials, an "IUC Removal Form," and bundling IUC supplies were translated to an outpatient and perioperative setting to reduce CAUTIs.

FINDINGS

The CAUTI rate in urologic surgical patients requiring an IUC at discharge decreased from 12.5% to 8%. Preoperative IUC education increased from 0% to 100%. The average number of days the IUC was present was unchanged. The average postanesthesia care unit length of stay decreased from 1.98 to 1.32 hours, saving the organization $11,880.00. IUC removal appointments at discharge increased from 4% to 33% (P = .0146).

CONCLUSIONS

Implementation of consistent patient education and improved process for IUC removal reduced CAUTIs in this population.

摘要

目的

对于减少携带留置导尿管(IUC)出院的门诊泌尿外科肿瘤患者的导管相关尿路感染(CAUTIs),可用的策略很少。

设计

采用一种使用测量前 - 测量后结构的质量改进方法,来研究过程干预对减少CAUTIs的影响。

方法

将IUC门诊材料、“IUC拔除表”以及捆绑式IUC用品应用于门诊和围手术期环境,以减少CAUTIs。

结果

出院时需要IUC的泌尿外科手术患者的CAUTI率从12.5%降至8%。术前IUC教育从0%增加到100%。IUC留置的平均天数没有变化。麻醉后护理单元的平均住院时长从1.98小时降至1.32小时,为机构节省了11,880.00美元。出院时IUC拔除预约从4%增加到33%(P = 0.0146)。

结论

实施一致的患者教育和改进IUC拔除流程可减少该人群的CAUTIs。

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