應用電腦提醒拔除導尿管機制對導尿管使用及尿路感染之影響

Using a Computer Reminder to Reduce Usage of Urinary Catheterization and Urinary Tract Infections

黃萬翠(Wan‐Tsuei Huang) ； 王復德(Fu‐Der Wang) ； 陳瑛瑛(Yin‐Yin Chen) ； 孫淑美(Shu‐Mei Sun)

《護理暨健康照護研究》 10卷1期 (2014/03) Pp. 70-77

https://doi.org/10.6225/JNHR.10.1.70

摘要

Background: The urinary tract is the most common site of healthcare‐associated infections, and 80% of urinary tract infections are attributable to urinary catheterization. Avoiding inappropriate catheter use and removing unnecessary catheters are the best preventive strategies for this type of infection.Purpose: This study evaluates the effect of using a computer‐based reminder system on the rate of catheter-associated urinary tract infections, the number of catheterization days, and the use of urinary catheters.Methods: A retrospective study was performed in a medical center that instituted a computer‐based reminder system on April 19th, 2012. All patients fitted with indwelling urinary catheters for more than 24 hours were recruited as participants during the period January to June 2012. The system activates when the catheterization patient's name is selected. Reminders that pop up automatically provide current data on number of catheterization days and assess the potential for early catheter removal.Results: A total of 8520 patients were recruited. The utilization rate of indwelling urinary catheters decreased significantly from 18.05% before the intervention to 16.23% afterward (p＜.001); the duration of catheterization shortened from 8.68 days to 8.10 days (p=.206); and the rate of catheter‐associated urinary tract infections decreased from 3.32 per mille to 2.62 per mille (p=.112), there's no statistically significant difference.Conclusion: The computer reminder system helps physicians and nurses keep accurate track of indwelling catheters and remove them as soon as possible. The results of this study suggest that this system is an effective approach to reducing the duration of indwelling urinary catheter use for patients.

關鍵字

感染 ； 尿路感染 ； 電腦提醒機制 ； 感染管制

並列摘要

Background: The urinary tract is the most common site of healthcare‐associated infections, and 80% of urinary tract infections are attributable to urinary catheterization. Avoiding inappropriate catheter use and removing unnecessary catheters are the best preventive strategies for this type of infection.Purpose: This study evaluates the effect of using a computer‐based reminder system on the rate of catheter-associated urinary tract infections, the number of catheterization days, and the use of urinary catheters.Methods: A retrospective study was performed in a medical center that instituted a computer‐based reminder system on April 19th, 2012. All patients fitted with indwelling urinary catheters for more than 24 hours were recruited as participants during the period January to June 2012. The system activates when the catheterization patient's name is selected. Reminders that pop up automatically provide current data on number of catheterization days and assess the potential for early catheter removal.Results: A total of 8520 patients were recruited. The utilization rate of indwelling urinary catheters decreased significantly from 18.05% before the intervention to 16.23% afterward (p＜.001); the duration of catheterization shortened from 8.68 days to 8.10 days (p=.206); and the rate of catheter‐associated urinary tract infections decreased from 3.32 per mille to 2.62 per mille (p=.112), there's no statistically significant difference.Conclusion: The computer reminder system helps physicians and nurses keep accurate track of indwelling catheters and remove them as soon as possible. The results of this study suggest that this system is an effective approach to reducing the duration of indwelling urinary catheter use for patients.

並列關鍵字

infections ； urinary tract infection ； computer reminder ； infection control

參考文獻

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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. doi:10.4037/ajcc2013464

Chen, Y. Y., Wang, F. D., Liu, C. Y., & Chou, P. (2009). Incidence rate and variable cost of nosocomial infections in different types of intensive care units. Infection Control and Hospital Epidemiology, 30(1), 39−46. doi:10.1086/ 592984