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导尿管缓解导航协议(UCANP):在单个三级医疗保健中心进行全院实施的更新。

Urinary catheter alleviation navigator protocol (UCANP): Update to the hospital-wide implementation at a single tertiary health care center.

机构信息

Quality Administration, Henry Ford Health, Detroit, MI.

Department of Urology, Henry Ford Health, Detroit, MI.

出版信息

Am J Infect Control. 2024 Nov;52(11):1269-1272. doi: 10.1016/j.ajic.2024.06.001. Epub 2024 Jun 12.

DOI:10.1016/j.ajic.2024.06.001
PMID:38876167
Abstract

BACKGROUND

Catheter-associated urinary tract infections are commonly reported health care-associated infections. It was demonstrated that the urinary catheter alleviation navigator protocol (UCANP) pilot resulted in a reduction of catheter utilization and catheter days.

METHODS

Quality improvement initiative that was implemented at a single urban, tertiary health care center, focusing on early discontinuation of indwelling urinary catheters (IUCs) and avoidance of reinsertion. The protocol was expanded hospital-wide from September 2020 to April 2022. We compared IUC utilization, IUC standardized utilization ratio (SUR), and catheter-associated urinary tract infection standardized infection ratio in the preintervention period (March 2020 to August 2020) to the postintervention period (May 2022 to October 2022).

RESULTS

Preimplementation, 2 patients with IUC removal were placed on UCANP. Postimplementation, 835 (45%) patients with IUC removal participated in the protocol. The number of patients requiring IUC reinsertion did not differ among the 2 groups. IUC utilization was significantly decreased from 0.28 to 0.24 with a 14% reduction (P = .025). SUR decreased by 11% from 0.778 to 0.693 (P = .007) and standardized infection ratio by 84% from 0.311 to 0.049 (P = .009).

CONCLUSIONS

Our protocol significantly reduced IUC utilization and SUR after hospital-wide implementation. UCANP is a safe and effective strategy that can potentially decrease unnecessary IUCs in patients with transient urinary retention.

摘要

背景

与导尿管相关的尿路感染是常见的医疗保健相关感染。研究表明,导尿管缓解导航协议(UCANP)试点导致导尿管使用率和留置天数减少。

方法

在一家城市三级保健中心实施的质量改进举措,重点是尽早停止留置导尿管(IUC)和避免重新插入。该协议于 2020 年 9 月至 2022 年 4 月在全院范围内扩大实施。我们比较了干预前(2020 年 3 月至 2020 年 8 月)和干预后(2022 年 5 月至 2022 年 10 月)IUC 使用率、IUC 标准化使用率(SUR)和与导尿管相关的尿路感染标准化感染率。

结果

在实施前,有 2 例 IUC 去除患者被纳入 UCANP。实施后,有 835 例(45%)IUC 去除患者参与了该协议。两组需要重新插入 IUC 的患者数量没有差异。IUC 使用率从 0.28 降至 0.24,下降 14%(P =.025)。SUR 下降 11%,从 0.778 降至 0.693(P =.007),标准化感染率下降 84%,从 0.311 降至 0.049(P =.009)。

结论

我们的协议在全院范围内实施后,显著降低了 IUC 的使用率和 SUR。UCANP 是一种安全有效的策略,可减少因短暂性尿潴留而需要的不必要的 IUC。

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