導尿管相關泌尿道感染(Catheter-Associated Urinary Tract Infection, CAUTI)影響醫療成本及住院天數增加。本單位2013年CAUTI感染密度千分之5.1,高於全院外科加護病房的千分之3.9。本專案目標為降低感染密度至千分之3.9以下。分析原因為:1.關於CAUTI認知不正確;2.放置導尿管及會陰護理技術不正確;3.缺乏留置導尿管適應症的指標;4.未規範留置導尿管的護理標準;5.手套放置設備不足。藉由實施在職教育、技術稽核、制定留置導尿管適應症與落實照護標準,CAUTI感染密度從千分之5.1下降至千分之3.5;專案結果可增加護理師對CAUTI照護知能,提升護理品質促進病人安全。
Catheter-associated urinary tract infection (CAUTI) increases health care costs and the lengths of hospital stays. The incidence density of the CAUTI at our unit in 2013 was 5.1 per mille which was higher than the average (3.9 per mille) of all surgical intensive care units. Therefore, this project aimed to decrease the incidence density to below 3.9 per mille. The causes of the high incidence density are the (1) incorrect cognition of CAUTI, (2) incorrect nursing skills of urinary catheter insertion and perineal care, (3) lack of the indications of using catheterization, (4) lack of developing standards of nursing care for urinary catheter maintenance, and (5) the insufficient equipment of glove replacement. After establishing the in-service education, the technical audit, indications of using catheterization, and the standard of nursing skills, the incidence densities of CAUTI decreased from 5.1 per mille to 3.5 per mille. This project effectively increased the nurses' knowledge about CAUTI and improved quality of nursing care and patient safety.