降低內科加護病房泌尿道感染率之改善專案

Quality Improvement Project: To Improve Catheter-Associated Urinary Tract Infection Rates in a Medical Intensive Care Unit

邱咨華(Zih-Hua Ciou) ； 徐盈真(Ying-Chen Hsu) ； 林麗芬(Li-Fen Lin) ； 王雅香(Ya-Hsiang Wang)

《志為護理-慈濟護理雜誌》 14卷1期 (2015/02) Pp. 62-73

摘要

導尿管為加護病房內常見留置的管路，而泌尿道是院內感染發生率最高，亦為本加護病房感染率之冠，故著手進行專案改善。經查檢、分析確立問題為：缺乏預防泌尿道感染照護標準、護理人員對感染控制照護不正確、缺乏集尿容器清潔規範。組員參考文獻及發揮創意擬定對策，包括修訂預防泌尿道感染照護標準、修訂擦澡及護理常規模式、舉辦在職教育課程、成立手部衛生種子人員及製訂集尿容器清潔規範等改善對策，於實施改善措施後泌尿道感染率由千分之3.6下降為0，本專案的實施確實改善泌尿道感染率，也提升護理人員對於感染控制照護執行的正確性及護理團隊為品質改善付出的凝聚力。

關鍵字

泌尿道感染 ； 加護病房 ； 感染率

並列摘要

A urinary catheter is the most common indwelling device in intensive care unit. Nosocomial urinary tract infections often occur in patients with with an indwelling urinary catheter. In order to reduce the incidence rate of urinary tract infection in our Medical Intensive Care Unit (MICU), we proposed an improvement project. We explored and found the most likely causes of urinary tract infection, such as lack of nursing standard of care protocol in preventing catheter-associated urinary tract infection (CAUTI), incorrect infection control practices, and lack of standardized procedures for cleaning urine specimen containers. We reviewed literature and proposed strategies for improving nursing care, including amendments to the care standard for the prevention of CAUTI and standard bath routine, providing staff continuing education , training employees to ensure proper handwashing procedures, and developing guideline for cleaning specimen containers. The post-implementation review showed that the CAUTI rate has decreased from 3.6 per mille to 0. The project has reduced infection rate, enhanced performance of infection control, and uplifted the team spirit to guide efforts to improve health care quality.

並列關鍵字

infection rate ； medical intensive care unit ； urinary tract infection