摘要
目的 了解《导尿管相关感染防控最佳实践专家共识》在上海各级医院的应用情况。方法 根据由蔡虻主编的《导管相关尿路感染防控最佳实践专家共识》一书设计调查问卷,2021年3-4月对上海市各级医院的护理工作人员导尿管相关尿路感染防控最佳实践应用情况进行调查。结果 导尿管相关感染防控最佳护理实践专家共识中的各项策略在上海各级医院实施率>70%的项目集中在手卫生、置管时严格执行无菌技术、导尿管的选择、导尿管及引流装置的固定4个方面。实施率在30%~70%的项目包括科室建立了专科留置尿管指征及护士对指征的了解、根据说明书要求更换导尿管、日常护理中尿液收集容器专用、尿液倾倒要求、大便失禁患者便后对尿管的消毒、膀胱冲洗、质量管理中使用管理工具方法降低尿路感染发生率和开展对专家共识的学习共10个条目;实施率<30%的项目包括每日评估留置尿管留置必要性、根据说明书要求更换集尿袋、拔除导尿管前不进行膀胱功能锻炼及常规使用清水或生理盐水进行留置尿管的日常清洁护理4个条目。不同类别医院间导尿管相关感染防控最佳护理实践临床落实较差情况比较,差异有统计学意义(P<0.05)。结论 《导尿管相关尿路感染防控最佳实践专家共识》在上海市各级医院未完全落实,如何将以循证为基础的共识策略更好地应用于临床,仍是当前重要任务之一。
OBJECTIVE To understand the application of the expert consensus on the best practice for the prevention and control of catheter-related infections in hospitals at all levels in Shanghai. METHODS According to the book "Expert Consensus on Best Practices for the Prevention and Control of Urinary Catheter-related Infections" edited by Cai Meng, a questionnaire was designed, and the best practice application for the prevention and control of catheter-related urinary tract infections among nursing staff in hospitals at all levels in Shanghai was investigated. RESULTS The project with an implementation rate of more than 70% of various strategies among the expert consensus of best nursing practice of catheter-related infection prevention and control in hospitals at all levels in Shanghai focused on four aspects such as hand hygiene, strict implementation of aseptic technique during catheter placement, selection of catheter, and fixation of catheter and drainage device. Projects with an implementation rate of 30% to 70% had a total of 10 items, including the establishment of specialist indwelling catheter indications by the department and nurse’s understanding of the indications, the replacement catheter according to the instructions, the special use of urine collection container in daily care, requirements of urine dumping, disinfection of urinary catheter after fecal incontinence, washing of bladder, use of management tools in quality management to reduce the incidence of urinary tract infections, and learning of expert consensus;Projects with an implementation rate of less than 30% had 4 items, including daily assessment on the necessity of indwelling urinary catheter, replacement of the collecting bag according to the instructions, no bladder washing before removing the catheter, and daily cleaning care with routinely using clean water or normal saline for indwelling catheter. There was a statistically significant difference in the poor clinical practice implementation of the best nursing practice for the prevention and control of catheter-related infections among different hospitals(P<0.05). CONCLUSION The "Expert Consensus on Best Practices for Prevention and Control of Urinary Catheter-related Urinary Tract Infections" has not been fully implemented in hospitals at all levels in Shanghai. How to better apply evidence-based consensus strategy to the clinic is still one of the important tasks at present.
作者
李玲玲
彭飞
裴禹童
任雪宁
张群
LI Ling-ling;PENG Fei;PEI Yu-tong;REN Xue ning;ZHANG Qun(Shanghai Changzheng Hospital,Shanghai 200003,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2022年第12期1866-1870,共5页
Chinese Journal of Nosocomiology
基金
长征医院军事医学科研专项基金资助项目(2019CZJS210-1)。
关键词
导尿管相关感染
最佳护理实践
专家共识
留置导尿
调查
Catheter-related infection
Best nursing practice
Expert consensus
Indwelling catheterization
Investigate
