探討組合式照護介入對加護病房病人預防泌尿道感染之成效

Exploring the Effect of Combined Care Intervention on Prevention of Urinary Tract Infection in Patients in Intensive Care Units

李光貿(Guang-Mao Lee) ； 陳美英(Mee-Jing Chen) ； 孫鳳卿(Feng-Ching Sun)

《高雄護理雜誌》 Volume 38 Issue 1 (2021/04) Pp. 14-21

https://doi.org/10.6692/KJN.202104_38(1).0002

Abstracts

背景：依據醫策會台灣臨床成效指標系統資料顯示，2019年成人加護病房病人留置導尿管年平均使用率為71.69%，導管相關泌尿道感染（catheter-associated urinary tract infection, CAUTI）年平均發生率為（千分之2.22），全國區域醫院加護病房感染部位與導管使用相關佔率為88.3%，其中以泌尿道感染位居第一。目的：探討組合式介入措施對於留置導尿管相關泌尿道感染之成效。方法：以系統性文獻回顧分析組合式照護模式對於留置導尿管之病人，預防泌尿道感染之成效。結果：共納入三篇隨機對照試驗文獻，結果發現導管相關組合式照護措施可有效降低導管相關之泌尿道感染發生。結論：如能定期更新修訂並強化其知識技能，不僅可以增加自我專業提升病人安全及品質外，亦可以減少醫療健保成本之增加，故建議未來研究可多針對組合式照護模式進行探討與研究，以增進國內之醫療品質提升。

Keywords

組合式照護 ； 加護病房 ； 留置導尿管相關泌尿道感染

Parallel abstracts

Background: According to the data of the 2019 Taiwan Medical Effectiveness Index System of the Medical Policy Council, the use rate of indwelling catheters is 71.69%, and the incidence of catheter-associated urinary tract infection (CAUTI) is (2.22 per mille). The proportion of infection sites and catheter use in intensive care units of regional hospitals was 88.3%, so urinary tract infections ranked first. Objective: To explore the effectiveness of combined interventional measures for indwelling catheter-related urinary tract infections. Methods: A systematic review of the effectiveness of the combined care model for patients with indwelling catheters to prevent urinary tract infections. Results: A total of three articles were included, and it was found that the catheter-related combined care model can effectively reduce the risk of infection. Conclusion: If can regularly update and strengthen knowledge and skills, can not only increase professionalism and improve patient safety and quality, but also reduce the cost of medical health insurance. Therefore, it is recommended that future research can be more focused on combined care models. To improve the domestic medical quality.

Parallel keywords

Bundle Care ； Intensive Care Unit ； Catheter-associated Urinary tract infection ； CAUTI

References

許牧晴、張藏能、陳瑞貞、陳銘耑(2019)．內科加護病房導尿管相關泌尿道感染之危險因子調查．感染控制雜誌，29(2)，53-63。https://doi.org/10.6526/ICJ.201904_29(2).0001

陳姍婷、程瓊嬅、范麗桂(2019)．提升導尿管相關泌尿道感染組合式照護完整率．台大護理雜誌，15(1)，218-232。https://doi.org/10.6740/NTUHJN.201901_15(1).0019

林佳蓓、陳媛綸、鍾翰其(2017)．降低呼吸器相關肺炎及導尿管相關泌尿道感染組合式措施推動與成果．醫療品質雜誌，11(5)，4-9。https://doi.org/10.30160/JHQ

許佳月、許惠宜、許雅婷(2016)．應用組合式照護模式降低泌尿道感染．醫療品質雜誌，10(6)，48-54。https://doi.org/10.30160/JHQ

Chen, Y. Y., Chi, M. M., Chen, Y. C., Chan, Y. J., Chou, S. S., & Wang, F. D. (2013). Using a criteria-based reminder to reduce use of indwelling urinary catheters and decrease urinary tract infections. American Journal of Critical Care, 22(2), 105-114. https://doi.org/10.4037/ajcc2013464