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留置导尿管的使用情况及对临床实践指南的遵循情况:一项针对成年住院患者的现况研究

Indwelling urinary catheter use and adherence to clinical practice guidelines: A point prevalence study in adult hospital inpatients.

作者信息

Wickins Jane, Rickard Claire M, Kasper Karen, Morton Leanne, Doellinger Jessica, Thomas-Gabbett Patricia, Marsh Nicole

机构信息

Herston Infectious Diseases Institute, The Prince Charles Hospital, Chermside, QLD, Australia.

School of Nursing, Midwifery and Social Work, The University of Queensland Centre for Clinical Research, Brisbane, QLD, Australia.

出版信息

J Infect Prev. 2024 Aug 7:17571774241270995. doi: 10.1177/17571774241270995.

Abstract

BACKGROUND

Approximately 25% of hospitalised adults require an indwelling urinary catheter (IDC) during their hospital stay. IDCs expose patients to risks of infectious and non-infectious complications.

AIMS

To identify IDC prevalence, assess adherence to clinical practice guidelines and patient-reported involvement in IDC care for adult hospital inpatients.

METHODS

This point prevalence study was conducted in 22 wards in a single quaternary hospital. Data was collected by clinical and research nurses working in pairs on a single day. Study outcomes were reported descriptively as frequencies and percentages.

RESULTS

Of 502 patients included, 77 (15.3%) had an IDC (median duration 99.6 h). The median age of patients with an IDC was 64 years (interquartile range 22-88 years), 54 (70%) were male and one-quarter ( = 19; 25%) of IDCs were inserted at another hospital. More than half ( = 44; 57%) of the 77 IDCs had no documented removal plan. Three patients were unavailable for review for observed clinical practices, and it was found 43% ( = 32/74) lacked a securement device. Of 77 people with IDCs, there were 44 patient responses, and 27 (61.4%) patients did not know the reason for their catheter.

DISCUSSION

Areas for improvement included securement device use, timely removal plans and patient education for the reason for the device. Regular point prevalence studies to assess use and adherence to clinical practical guidelines can improve safety outcomes for patients requiring IDCs.

摘要

背景

约25%的住院成人在住院期间需要留置导尿管(IDC)。IDC会使患者面临感染性和非感染性并发症的风险。

目的

确定成人住院患者的IDC患病率,评估对临床实践指南的依从性以及患者报告的参与IDC护理情况。

方法

这项现况调查研究在一家单一的四级医院的22个病房进行。数据由临床护士和研究护士在同一天成对收集。研究结果以频率和百分比的形式进行描述性报告。

结果

在纳入的502名患者中,77名(15.3%)留置了导尿管(中位时长99.6小时)。留置导尿管患者的中位年龄为64岁(四分位间距22 - 88岁),54名(70%)为男性,四分之一( = 19;25%)的导尿管是在另一家医院插入的。77根导尿管中超过一半( = 44;57%)没有记录的拔除计划。有3名患者因观察临床操作而无法接受复查,发现43%( = 32/74)缺乏固定装置。在77名留置导尿管的患者中,有44名患者做出了回应,27名(61.4%)患者不知道留置导尿管的原因。

讨论

需要改进的方面包括固定装置的使用、及时的拔除计划以及对患者进行关于留置导尿管原因的教育。定期进行现况调查研究以评估使用情况和对临床实践指南的依从性,可以改善需要留置导尿管患者的安全结局。

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本文引用的文献

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Strategies for the removal of short-term indwelling urethral catheters in adults.成人短期留置导尿管拔出策略。
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