Internal Medicine, Infectious Diseases, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, Netherlands.
Medical Psychology, Amsterdam UMC, University of Amsterdam, Meibergdreef 15, Amsterdam, Netherlands.
World J Urol. 2020 Jan;38(1):57-62. doi: 10.1007/s00345-018-02623-4. Epub 2019 Jan 24.
Inappropriate use of urinary and intravenous catheters is still frequent. The use of catheters is associated with some serious complications, such as health care associated infections (HAIs). An efficient way to reduce HAIs is to avoid inappropriate use of catheters, but the role for patients in quality improvement initiatives is unclear. The aim of this study is to investigate patients knowledge and experience with catheters, to design patient interventions to reduce inappropriate catheter use.
We assessed patient's knowledge and experience with catheters using a self report questionnaire, and included patients with a urinary and/or peripheral intravenous catheter (PIVC) during the baseline measurements of a quality improvement project to reduce inappropriate catheters use.
A total number of 82 patients completed the questionnaire, of which 49 had a urinary catheter and 72 a PIVC. Patients were unaware about the indication for their urinary catheter in 20.9% and PIVC in 19.5%. Nevertheless, 65.3% reported symptoms due to urinary catheters and 37.5% for PIVCs. Interestingly, only 25.5% and 22.4% reported that they would ask their doctor if the catheter could be removed.
There is a lack of knowledge about the indication for having a urinary and peripheral intravenous catheter in a substantial part of patients. Although catheters cause symptoms, patients in general do not ask if the catheter could be removed. Doctors should give more information and ask more questions about catheters to their patients. Quality improvement initiatives stimulating patients to actively participate in their treatment are needed.
不恰当地使用导尿管和静脉内导管仍然很常见。导管的使用与一些严重的并发症有关,如与医疗保健相关的感染(HAIs)。减少 HAIs 的有效方法是避免不恰当地使用导管,但患者在质量改进计划中的作用尚不清楚。本研究旨在调查患者对导管的了解和经验,设计减少不适当导管使用的患者干预措施。
我们使用自我报告问卷评估了患者对导管的了解和经验,并在一项旨在减少不适当导管使用的质量改进项目的基线测量中纳入了具有导尿管和/或外周静脉导管(PIVC)的患者。
共有 82 名患者完成了问卷,其中 49 名患者有导尿管,72 名患者有 PIVC。20.9%的患者不知道其导尿管的适应证,19.5%的患者不知道 PIVC 的适应证。尽管如此,65.3%的患者报告了由于导尿管引起的症状,37.5%的患者报告了由于 PIVC 引起的症状。有趣的是,只有 25.5%和 22.4%的患者报告说如果导管可以去除,他们会询问医生。
相当一部分患者对留置导尿管和外周静脉导管的适应证缺乏了解。尽管导管会引起症状,但患者通常不会询问是否可以去除导管。医生应该向患者提供更多有关导管的信息,并询问更多有关导管的问题。需要开展激发患者积极参与治疗的质量改进计划。