以膀胱組合式照護降低導尿管相關泌尿道感染之專案

Reducing Catheter-Related Urinary Tract Infections by Combining Treatment with Bladder Care

林玗萱(Yu-Shiuan Lin) ； 蕭昭俐(Chao-Li Hsiao) ； 鍾淑貞(Shu-Chen Chuang) ； 鍾幸枝(Hsin-Chin Chuang)

《榮總護理》 34卷1期 (2017/03) Pp. 78-85

https://doi.org/10.6142/VGHN.34.1.78

摘要

本單位導尿管相關泌尿道感染密度平均6.2-6.3 per mille，2013 年1-8 月感染密度為10-14.1 per mille，顯示病人導尿管相關泌尿道感染密度有上升趨勢，故引發專案動機。現況分析發現有：一、拔除導尿管時機不一致；二、設備不完善及回饋資訊不足。為降低泌尿道感染密度，擬定改善對策：一、以「膀胱組合照護模式」的概念進行教育訓練；二、制訂留置導尿管適應症及拔除導尿管提醒機制；三、改善不合宜的設備、提供即時訊息回饋。經由專案措施後，2013 年9 月到2014 年4月改善成效為感染密度至6.0-8.1 per mille。顯示本專案具成效，透過本專案降低病人因導尿管留置引起之泌尿道感染，進而提升護理照護品質。

關鍵字

組合式照護 ； 泌尿道感染

並列摘要

The average infection rate of catheter-related urinary tract infection (UTI) is 6.2 per mille - 6.3 per mille in our intensive care unit. Between January 1 and August 31, 2013, the rate was 10 per mille - 14.1 per mille. The result showed that catheter-related urinary tract infection exhibited an increasing trend. This project aimed to reduce catheter-related UTIs by combining treatment with bladder care. We analyzed the current situation and identified two problems: (1) the time to remove the urinary catheter differs between cases and (2) there is a lack of equipment and feedback. To reduce the rate of UTI, we designed methods of (1) educating and training with a bladder combination model of care, (2) establishing indicators for urinary catheterization and a reminder mechanism for urinary catheter removal, and (3) upgrading equipment and providing instant feedback. After implementing this project, the infection rate was reduced to 6.0 per mille - 8.1 per mille for the period of September 1, 2013, to April 30, 2014. The results showed that the combination bladder care project reduced the catheter-related UTI rate and increased the quality of nursing care.

並列關鍵字

bladder care ； urinary tract infection

參考文獻

吳宛庭、王拔群、侯紹敏(2010)‧醫療機構推動團隊資源管理現況與建議‧醫品雜誌，4，78-80。

林詩淳、徐明洲、蔡坤維(2010)‧老年人常見之泌尿道感染‧志為護理，9(5)，66-67。

黃惠美、施智源、劉伯瑜(2012)‧運用醫療團隊資源管理於感管政策的落實‧感控雜誌，22(4)，170-174。

陳瑛瑛、王復德(2013)‧導尿管相關泌尿道感染管制策略‧感控雜誌，23(5)，261-270。

劉震龍、王育群、黃忠凱、翁郡珮、楊芝齡、錢慶文(2012)‧放置導尿管患者發生泌尿道感染之相關因子分析‧感控雜誌，22(1) ，1-11。