移除導尿管時機對病人感受、重插率及泌尿道感染之影響

A Comparison of the Effects of Night and Day Removal of Urinary Catheters on Patient Perceptions, Re-Catheterization Rates and Urinary Tract Infections

白玉珠(Yu‐Chu Pai) ； 江琳瑩(Lin‐Ying Chiang) ； 葉純宜(Chun‐Yi Yeh) ； 陳美娟(Mei‐Chuan Chen) ； 童惠芳(Hui‐Fang Tung) ； 柯秀錦(Xiu‐Jin Ke)

《護理暨健康照護研究》 9卷1期 (2013/03) Pp. 33-41

https://doi.org/10.6225/JNHR.09.1.33

摘要

Background: Patients with urinary tract infection (UTI) face increased risks of disease deterioration, prolonged hospitalization stays, higher healthcare costs, and mortality. Thus, it is important to select the proper time to remove unnecessary catheterization in order to reduce UTI incidence. Purpose: This study compares the time‐of‐day effects of urinary catheter removal on patient void times, void volumes, re‐catheterization rates, urinary tract infection rates, symptom distress levels, and self‐perception then analyzes their influential factors. Methods: Using a quasi‐experiment study design, patients were distributed into two urinary catheter removal time groups. The day group included 43 and the night group included 41 participants. Data related to urinary catheter removal and patient perceptions were collected and analyzed using descriptive and inferential statistics. Results: The night group had longer void times (251.3 vs. 177.9 mins, p ＜ .05) and a higher rate of re-catheterization (24.4% vs. 7.0%, p ＜ .05) than the day group. There were no differences in voided volume and UTI rate between the two groups. The odds ratio of re‐catheterization rate was 1.06 for per urinary day. After removing urethral catheterization in the two groups, the disturbance syndrome for all patients went into gradual remission, their negative perceptions were significantly reduced, and positive emotions such as comfort, relaxation and pleasure were significantly improved (p ＜ .05). Conclusion: Catheter removal timing did not result in significant differences in inter‐group void volumes or UTI rates. However, the night group had a higher re‐catheterization rate. Increased number of urethral catheterization days also correlated with increased re‐catheterization rate. The removal of the urinary catheter reduced syndrome disturbance and improved self‐perception. Therefore, we suggest that the urinary catheter removal order be implemented as soon as possible without considering the potential different effects of day / nighttime removal in order to maximize patient comfort and sleeping quality.

關鍵字

移除 ； 導尿管 ； 自我感受 ； 泌尿道感染

並列摘要

Background: Patients with urinary tract infection (UTI) face increased risks of disease deterioration, prolonged hospitalization stays, higher healthcare costs, and mortality. Thus, it is important to select the proper time to remove unnecessary catheterization in order to reduce UTI incidence. Purpose: This study compares the time‐of‐day effects of urinary catheter removal on patient void times, void volumes, re‐catheterization rates, urinary tract infection rates, symptom distress levels, and self‐perception then analyzes their influential factors. Methods: Using a quasi‐experiment study design, patients were distributed into two urinary catheter removal time groups. The day group included 43 and the night group included 41 participants. Data related to urinary catheter removal and patient perceptions were collected and analyzed using descriptive and inferential statistics. Results: The night group had longer void times (251.3 vs. 177.9 mins, p ＜ .05) and a higher rate of re-catheterization (24.4% vs. 7.0%, p ＜ .05) than the day group. There were no differences in voided volume and UTI rate between the two groups. The odds ratio of re‐catheterization rate was 1.06 for per urinary day. After removing urethral catheterization in the two groups, the disturbance syndrome for all patients went into gradual remission, their negative perceptions were significantly reduced, and positive emotions such as comfort, relaxation and pleasure were significantly improved (p ＜ .05). Conclusion: Catheter removal timing did not result in significant differences in inter‐group void volumes or UTI rates. However, the night group had a higher re‐catheterization rate. Increased number of urethral catheterization days also correlated with increased re‐catheterization rate. The removal of the urinary catheter reduced syndrome disturbance and improved self‐perception. Therefore, we suggest that the urinary catheter removal order be implemented as soon as possible without considering the potential different effects of day / nighttime removal in order to maximize patient comfort and sleeping quality.

並列關鍵字

removing ； urinary catheter ； self‐perception ； urinary tract infection