運用組合式照護降低內科病房泌尿道感染率

Bundle Care to Decrease the Nosocomial Urinary Tract Infection Rate in a Medical Ward

林玉汶(Yu-Wen Lin) ； 林若寧(Roth-Ning Lin) ； 張巧薇(Chiao-Wei Chang) ； 盧麗華(Li-Hua Lu) ； 蔡衣帆(Yi-Fan Tsai) ； 楊式辰(Shih Chen Yang)

《北市醫學雜誌》 14卷1期 (2017/03) Pp. 52-64

https://doi.org/10.6200/TCMJ.2017.14.1.05

摘要

本專案旨在探討運用組合式照護後是否可以降低某內科病房泌尿道感染密度。在2012 年全院泌尿道感染密度為1.98 per mille，而單位泌尿道感染密度為2.89 per mille，佔全院病房組泌尿道感染密度最高，因此運用組合式照護模式以降低內科病房泌尿道感染密度。經專案護理人員觀察照顧服務員（簡稱：照服員）執行留置導尿管照護技能及透過照護知識測驗，結果發現留置導尿管照護技能及認知錯誤，透過訪談與問卷調查分析導致主因有：未規範病人專屬尿壺、未規範留置導尿管移除機制、照服員留置導尿管照護技能與知識錯誤、無照服員留置導尿管照護技能稽核。經制訂專屬尿壺使用規範、留置導尿管移除時機與查檢表、製作留置導尿管照護多媒體光碟示教與實作、執行留置導尿管照護技能稽核等一整套組合式照護措施介入後，使內科病房泌尿道感染密度由改善前2.89 per mille下降至1.05 per mille，因此確認透過組合式照護模式是可以有效降低內科病人泌尿道感染。

關鍵字

組合式照護 ； 照顧服務員 ； 泌尿道感染密度

並列摘要

The project aimed to explore whether bundle care might decrease infection density of urinary tract infection in our medical ward. In 2012, the hospital urinary tract infection density was 1.98 per mille, while that in medical ward was 2.89 per mille, which was the highest among all wards. Analysis of the interviews and questionnaire data identified major causes of urinary tract infection, including a lack of individual urinals, unstandardized indwelling catheter removal procedures, skill and knowledge among nursing assistants in indwelling catheter care, and no audition for indwelling catheter care skills among nursing assistants. We stipulated the exclusive use of urinals, standardized the indwelling catheter removal procedures, made multimedia CD for education of indwelling catheter care, and set up examination of indwelling catheter care skills. The urinary tract infection density of our medical ward decreased from 2.89 per mille to 1.05 per mille. We confirmed that application of bundle care can reduce urinary tract infection density in medical ward.

並列關鍵字

Bundle Care ； Nursing Assistants ； urinary tract infection density