Wanat Marta, Borek Aleksandra J, Atkins Lou, Sallis Anna, Ashiru-Oredope Diane, Beech Elizabeth, Butler Christopher C, Chadborn Tim, Hopkins Susan, Jones Leah, McNulty Cliodna A M, Roberts Nia, Shaw Karen, Taborn Esther, Tonkin-Crine Sarah
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK.
Centre for Behaviour Change, University College London, London WC1E 6BT, UK.
Antibiotics (Basel). 2020 Jul 17;9(7):419. doi: 10.3390/antibiotics9070419.
Catheter-associated urinary tract infections (CAUTI) are common yet preventable. Healthcare professional behaviours, such as reducing unnecessary catheter use, are key for preventing CAUTI. Previous research has focused on identifying gaps in the national response to CAUTI in multiple settings in England. This study aimed to identify how national interventions could be optimised. We conducted a multi-method study comprising: a rapid review of research on interventions to reduce CAUTI; a behavioural analysis of effective research interventions compared to national interventions; and a stakeholder focus group and survey to identify the most promising options for optimising interventions. We identified 37 effective research interventions, mostly conducted in United States secondary care. A behavioural analysis of these interventions identified 39 intervention components as possible ways to optimise national interventions. Seven intervention components were prioritised by stakeholders. These included: checklists for discharge/admission to wards; information for patients and relatives about the pros/cons of catheters; setting and profession specific guidelines; standardised nationwide computer-based documentation; promotion of alternatives to catheter use; CAUTI champions; and bladder scanners. By combining research evidence, behavioural analysis and stakeholder feedback, we identified how national interventions to reduce CAUTI could be improved. The seven prioritised components should be considered for future implementation.
导尿管相关尿路感染(CAUTI)很常见但可预防。医护人员的行为,如减少不必要的导尿管使用,是预防CAUTI的关键。以往的研究主要集中在确定英格兰多个环境中全国对CAUTI应对措施的差距。本研究旨在确定如何优化国家干预措施。我们进行了一项多方法研究,包括:快速回顾关于减少CAUTI干预措施的研究;将有效的研究干预措施与国家干预措施进行行为分析;以及开展利益相关者焦点小组和调查,以确定优化干预措施最有前景的选项。我们确定了37项有效的研究干预措施,大多在美国二级护理机构开展。对这些干预措施的行为分析确定了39个干预组成部分,作为优化国家干预措施的可能方式。利益相关者将七个干预组成部分列为优先事项。这些包括:病房出院/入院检查表;向患者及其亲属提供关于导尿管利弊的信息;针对不同场所和专业的指南;全国标准化的基于计算机的文档记录;推广导尿管使用的替代方法;CAUTI倡导者;以及膀胱扫描仪。通过结合研究证据、行为分析和利益相关者反馈,我们确定了如何改进减少CAUTI的国家干预措施。应考虑未来实施这七个优先组成部分。