Master of Science in Clinical Science and Technology, Aalborg University Hospital, Orthopedic Division, Clinic Farsoe, Denmark.
Master of Clinical Nursing, Aalborg University Hospital, Orthopedic Division, Clinic Hjoerring, Denmark.
Int J Orthop Trauma Nurs. 2021 Apr;41:100851. doi: 10.1016/j.ijotn.2021.100851. Epub 2021 Mar 2.
Urinary tract infection (UTI) is a frequent complication of hip fractures. The Danish national clinical guideline for hip fracture recommends early and systematic mobilisation after surgery and that indwelling catheters are not used perioperatively.
The aim of this study was to describe the number of patients who received nursing care to prevent UTIs in accordance with the recommendations from the national Danish clinical guidelines. Specifically, the aim was to report the number of patients developing UTIs during admission, have indwelling catheters removed and being mobilised with 24 hours after surgery.
This prospective study included 65 patients. Data were collected on mobilisation and catheter use with a chart designed for this study. Sterile intermittent catheterisation was used to collect urine samples on admission and at discharge. Urine samples were sent for analysis at the microbiology laboratory. The urine sample was positive for UTI if the test showed 10 CFU/ml bacteria.
A total of five patients contracted nosocomial UTI during their hospital stay (7.7%), while 29.2% of patients had a positive urine culture on admission and were treated for UTI. At discharge, 20% of the patients had a positive urine sample but no symptoms. Postoperatively, 52.3% of the patients were mobilised within 24 hours.
The incidence of nosocomial UTI was similar to what has been found in other studies (95% [CI], 0.03-0.17]). The percentage of patients with nosocomial UTI was 7.7%. Nursing care related to hygienic performance of catheterisation or intermittent catheterisation adhered to the Danish national clinical guidelines, and 52.3% of the patients were mobilised within 24 h after surgery, which showed low adherence to the guidelines.
尿路感染（UTI）是髋部骨折的常见并发症。丹麦国家髋部骨折临床指南建议术后尽早进行系统的活动，且围手术期不使用留置导尿管。
本研究旨在描述根据丹麦国家临床指南建议接受预防 UTI 护理的患者数量。具体而言，目的是报告在住院期间发生 UTI、拔除留置导尿管和术后 24 小时内开始活动的患者数量。
这是一项前瞻性研究，共纳入 65 名患者。使用为此研究设计的图表收集关于活动和导管使用的数据。使用无菌间歇导尿收集入院时和出院时的尿液样本。将尿液样本送到微生物实验室进行分析。如果测试显示 10 CFU/ml 细菌，则尿液样本呈阳性，表明存在 UTI。
共有 5 名患者在住院期间（7.7%）发生医院获得性 UTI，而 29.2%的患者入院时尿液培养阳性，并接受 UTI 治疗。出院时，20%的患者尿液样本呈阳性但无症状。术后，52.3%的患者在 24 小时内开始活动。
医院获得性 UTI 的发生率与其他研究相似（95%[CI]，0.03-0.17）。医院获得性 UTI 的患者比例为 7.7%。与导管护理或间歇导尿的卫生性能相关的护理符合丹麦国家临床指南，并且 52.3%的患者在术后 24 小时内开始活动，这表明对指南的依从性较低。
