目标性监测与综合干预对降低非ICU患者导尿管相关尿路感染的效果  

Effect of targeted monitoring and comprehensive intervention on reducing catheter-associated urinary tract infection in patients in non-intensive care unit

作　　者：孔立[1] 李玉森[1] 赵战魁[1] 胡慧芳[1] 郭金凤[1] 刘宏[1] 王娟[1] 王吉霞[1] 刘淼[1] 李宁[1] 岳霞[1] 张丁丁[1] 马永辉[1] KONG Li LI Yu-sen ZHAO Zhan-kui HU Hui- fang GUO Jin-feng LIU Hong WANG Juan WANG Ji-xia LIU Miao LI Ning YUE Xia ZHANG Ding-ding MA Yong-hui(Affiliated Hospital of Jining Medical College, Jining 272000, Chin)

机构地区：[1]济宁医学院附属医院,山东济宁272000

出　　处：《中国感染控制杂志》2017年第8期721-725,共5页Chinese Journal of Infection Control

摘　　要：目的评价采取目标性监测与综合干预措施对降低非重症监护病房患者导尿管相关尿路感染(CAUTI)的效果。方法 2015年4季度对该院临床科室留置导尿管患者进行基线调查(干预前),查找导致患者发生CAUTI的危险因素,2016年开始制定目标性监测方案及综合干预措施(干预后),比较干预前后CAUTI发病率。结果采取干预措施后,手卫生的依从率由2015年4季度的78.51%提高至2016年3季度的92.99%和2016年4季度的90.73%(χ~2值分别为7.342、3.998,均P<0.05),患者导尿系统处置正确率由2015年4季度的72.83%提高至2016年4度的95.44%(χ~2=30.267,P<0.05)。共监测12 067例留置导尿管患者,CAUTI发病率由2015年4季度(干预前)的1.03‰(24/23 313)下降至2016年4季度(干预后)的0.53‰(14/26 595),两者比较差异有统计学意义(χ~2=4.126,P=0.042)。结论通过目标性监测,提升留置导尿管患者导尿系统相关的环节质量,能有效降低非重症监护病房患者CAUTI发病率。Objective To evaluate the effect of targeted monitoring and comprehensive intervention measures on reducing the occurrence of catheter-associated urinary tract infection（CAUTI） in patients in non-intensive care unit （Non-ICU）. Methods In quarter 4 of 2015, patients with indwelling urinary catheter in clinical departments were conducted a baseline survey（before intervention）, risk factors for CAUTI in patients were analyzed, targeted monitoring programmes and comprehensive intervention measures were initiated in 2016（after intervention）, incidence of CAUTI before and after intervention was compared. Results After taking intervention measures, hand hygiene compliance rate increased from 78.51% in quarter 4 of 2015 to 92.99 % in quarter 3 of 2016 and 90.73 % in quarter 4 of 2016（x2 = 7. 342, 3. 998, respectively, both P〈0.05）, the correct disposal rate of patients＇ urinary catheterization system increased from 72.83% in quarter 4 of 2015 to 95.44% in quarter 4 of 2016（x2 = 30. 267,P〈0.05）. A total of 12 067 patients with indwelling urinary catheter were monitored, incidence of CAUTI dropped from 1.03%0 （24/23 313）in quarter 4 of 2015 （before intervention） to 0.53%o （14/26 595）in quarter 4 of 2016 （after intervention）, difference was statistically significant（x2 = 4. 126,P = 0. 042）. Conclusion Improving the quality of urinary catheterization system in patients with indwelling catheter through targeted monitoring can effectively reduce the in- cidence of CAUTI in patients in Non-ICU.

关 键 词：目标性监测 综合干预 非重症监护病房 导尿管相关尿路感染 

分 类 号：R181.32[医药卫生—流行病学]