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住院患者短期留置导尿管相关尿路感染的预防干预措施与策略:一项综合综述

Interventions and strategies to prevent catheter-associated urinary tract infections with short-term indwelling urinary catheters in hospitalized patients: An integrative review.

作者信息

Yu Shuhui, Marshall Andrea P, Li Jing, Lin Frances

机构信息

Urology Department, Peking University First Hospital, Beijing, China.

Menzies Health Institute Queensland, School of Nursing and Midwifery, Griffith University, Gold Coast Hospital and Health Service, Southport, Queensland, Australia.

出版信息

Int J Nurs Pract. 2020 Jun;26(3):e12834. doi: 10.1111/ijn.12834. Epub 2020 Mar 13.

Abstract

AIM

To explore interventions and strategies to prevent catheter-associated urinary tract infections in hospitalized patients with a short-term indwelling urinary catheter.

BACKGROUND

Interventions and strategies to prevent catheter-associated urinary tract infections are reported in the literature, but it is not clear which might be relevant when the indwelling urinary catheter is in place for a short period of time.

METHODS

An integrative review was performed. A search was undertaken in databases using the following search terms: "urinary catheter, bladder catheter OR urethral catheter*"and "bundl* OR care OR manag* OR intervent*." Electronic databases were searched up until June 2019. Manual searching of reference lists of included studies was undertaken. Twelve studies reported in 15 articles were identified and analysed by two independent reviewers.

RESULTS

Multifaceted interventions were informed by evidence-based protocols or guidelines. Implementation strategies included local adaption of guidelines or protocols, use of an opinion leader, audit and feedback, multidisciplinary team involvement, reminders and stop orders, and education and training.

CONCLUSION

Multifaceted, evidence-based interventions to prevent catheter-associated urinary tract infections are effective in preventing infections in patients with short-term urinary catheters. However, there is little evidence to inform which combined strategies are more likely to be effective.

摘要

目的

探讨针对短期留置导尿管的住院患者预防导管相关尿路感染的干预措施和策略。

背景

文献中报道了预防导管相关尿路感染的干预措施和策略,但对于短期留置导尿管时哪些措施可能相关尚不清楚。

方法

进行了一项综合综述。在数据库中使用以下检索词进行检索:“导尿管、膀胱导管或尿道导管*”以及“束集或护理或管理或干预*”。检索电子数据库至2019年6月。对纳入研究的参考文献列表进行手工检索。由两名独立评审员对15篇文章中报道的12项研究进行识别和分析。

结果

多方面干预措施以循证方案或指南为依据。实施策略包括对指南或方案进行本地化调整、使用意见领袖、审核与反馈、多学科团队参与、提醒与停止医嘱以及教育与培训。

结论

多方面的循证干预措施对于预防导管相关尿路感染在短期留置导尿管的患者中预防感染是有效的。然而,几乎没有证据表明哪些联合策略更有可能有效。

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