- 期刊
以實證探討住院老人移除留置尿管處理方案
Management of Urinary Catheter Removal among Hospitalized Older Adults: An Evidence-Based Approach
摘要
住院老人常因留置尿管導致併發症，其留置尿管盛行率約為15至25%。留置尿管導致多項併發症，不僅會延長住院天數，甚至與死亡率的增加有關。本文以文獻回顧法搜尋2002至2012年，發表於Pub-Med、Medline、Cochrane Library、National Guideline Clearinghouse、The Joanna Briggs Institute、The National Institute for Health and Clinical Excellence、思博網中文電子期刊等資料庫，鍵入下列關鍵字：老人膀胱再訓練（bladder retraining in elderly）、膀胱功能不良（bladder dysfunction）、神經性膀胱（neurogenic bladder）、尿管導致泌尿道感染（catheter associated urinary tract infection）、移除短期留置尿管（removal of short-term indwelling urinary catheter）、間歇性導尿（intermittent catheterization）等，選取符合篩選標準並排除不適合文獻後，共找出13篇文章進行分析與整理。利用文獻資料為基礎，整理出住院老人移除留置尿管處理方案。使用移除留置尿管的評量準則，分為可移除與不可移除兩大類型，針對可移除留置尿管的住院老人，選擇最佳移除的時間點，最後規劃出移除留置尿管後的流程計劃，減低產生排尿問題的危險性及增加移除留置尿管的成功率。故期望藉此方案之建構，減少臨床住院老人不當使用留置導尿管的情形。
並列摘要
Approximately 15 to 25% of hospitalized elderly patients need to use urinary catheters. In addition to prolonged hospital stay, catheter-associated urinary tract infections and other complications may even lead to increased mortality rate. Removal of urinary catheter is therefore a matter of considerable importance for hospitalized elderly patients. The study accordingly performed a literature review on related papers published during the period from 2002 to 2012. Literature published in ”Pub-Med,” ”Medline,” ”Cochrane Library,” ”National Guideline Clearinghouse,” ”The Joanna Briggs Institute,” ”The National Institute for Health and Clinical Excellence,” and ”CEPS” were searched, using keywords including ”bladder retraining in elderly,” ”bladder dysfunction,” ”neurogenic bladder,” ”catheter associated urinary tract infection,” ”removal of short-term indwelling urinary catheter,” and ”intermittent catheterization”. The online keyword search produced 13 articles serving as the evidence-based documents examined by the study that aimed at reviewing the protocol of removing urinary catheters among hospitalized older adults. Based on the ways the cases were managed, the protocol is categorized into the removable and the non-removable types. The optimal timing for removing urinary catheters among removable cases was then determined, and, finally, effective strategies for bladder retraining were proposed to help decrease the risk of infections and complications and increase the rate of successful removal for hospitalized elderly patients using urinary catheters.