應用「導尿管移除評估指標」對降低泌尿道感染之成效

Effectiveness of Guidelines for Removal of Indwelling Urinary Catheter to Reduce Urinary Tract Infections

紀美滿(Mei-Man Chi) ； 陳瑛瑛(Yin-Yin Chen)

《台灣醫學》 17卷3期 (2013/05) Pp. 238-245

https://doi.org/10.6320/FJM.2013.17(3).02

摘要

本研究目的在探討應用「導尿管移除評估指標」對病人泌尿道感染發生率及住院天數之影響。採隨機分配的實驗性研究設計，於台灣北部2900床的醫學中心之胸腔重症加護室及呼吸治療加護室，共收案278位導尿管留置病人。將所有病人隨機分配至實驗組與對照組，實驗組於導尿管留置第7天，以「導尿管移除評估指標」評估，確定無符合指標即移除導尿管，對照組則未使用「導尿管移除評估表」。結果發現實施「導尿管移除評估指標」後每千置管天數中泌尿道感染危險機率由千分之18.4降至千分之14.4（p=.036），導尿管留置天數由15.8天縮短至12.3天（p=.018）；在總住院天數（p=.898）及加護病房天數（p=.244）方面皆未達統計上顯著差異。證實執行「導尿管移除評估指標」能早期移除導尿管，並有效降低泌尿道感染發生率。

關鍵字

導尿管 ； 泌尿道感染 ； 導尿管移除指標

並列摘要

The objective of this study was to compare the effectiveness by using guidelines governing the removal of indwelling catheters on the reduction of catheter-related urinary tract infections (UTIs). This is an open-labeled, randomized, controlled study. The study sites were two intensive care units (ICUs) at a 2,900-bed medical center. A total of 278 subjects who underwent Foley catheter insertion were recruited. All patients were randomized into control group or experimental group, ”Foley catheter evaluation sheet” was used for experimental group to assess the necessity of catheter and whether it was suitable to remove the unnecessary catheter on the 7th day. Early catheter removal was found to reduce incidence of UTI (p= .036) in the experimental group. There was a significantly shorter average duration of catheterization in the experimental group (12.3 days vs 15.8 days for the control group; p= .018). There was no significant difference in the total length of hospital and ICU stay (p＞ .05). The use of guidelines for determining when to remove indwelled urinary catheters can reduce the risk of UTI, shorten the duration of urinary catheterization.

並列關鍵字

Foley catheter ； urinary tract infection ； indicator of Foley catheter removal