Schmudde Yvonne, Olson-Sitki Kristi, Bond Jennifer, Chamberlain Jill
Kristi Olson-Sitki, MSN, RN, NE-BC, is Magnet coordinator at Memorial Medical Center, Springfield, Illinois. Yvonne Schmudde, MS, RN, CCRN, CNE, is nursing outcomes improvement facilitator at Memorial Medical Center, Springfield, Illinois. Jennifer Bond, MS, RN-BC, CCRN-K, is director of Professional Nursing Practice at Memorial Medical Center, Springfield, Illinois. Jill Chamberlain, PhD, RN, CNE, CHSE, is manager of Nursing Research at Memorial Medical Center, Springfield, Illinois.
Dimens Crit Care Nurs. 2019 Sep/Oct;38(5):236-240. doi: 10.1097/DCC.0000000000000371.
Urinary tract infections are the most common type of health care-associated infection, and greater than 75% of them are attributed to an indwelling urinary catheter. A catheter-associated urinary infection may lead to a longer hospital length of stay by as many as 4 days. A new patient care standard requiring twice-daily chlorhexidine cleansing from umbilicus to knees was implemented on all patients of the pilot unit with a urinary catheter. This same technique was used after a patient with a urinary catheter had an incontinent bowel movement. The 9-month average catheter-associated urinary infection rate decreased from 3.06/1000 urinary catheter days to 0.46/1000 urinary catheter days after implementation of the new standard. The use of chlorhexidine for routine urinary catheter care and after bowel movements from umbilicus to knees for patients with urinary catheters may significantly decrease catheter-associated urinary tract infections when compared with the standard of care using soap and water. Standards for Quality Improvement Reporting Excellence guidelines were used in reporting these data.
尿路感染是医疗保健相关感染中最常见的类型，其中超过75% 归因于留置导尿管。导尿管相关的泌尿系统感染可能会使住院时间延长多达4天。一项新的患者护理标准要求对试点病房所有留置导尿管的患者，每天两次用洗必泰从脐部至膝盖进行清洁。在留置导尿管的患者发生大便失禁后也采用同样的方法。实施新标准后，9个月的平均导尿管相关泌尿系统感染率从每1000导尿管日3.06例降至每1000导尿管日0.46例。与使用肥皂和水的护理标准相比，对留置导尿管的患者在常规导尿管护理时以及大便失禁后从脐部至膝盖使用洗必泰，可能会显著降低导尿管相关的尿路感染。报告这些数据时采用了卓越质量改进报告标准指南。
