护士主导的儿童导尿管拔除评估模式的临床应用研究  

Clinical application of nurse-led catheter extraction assessment model in children

作　　者：邓亚晴 春晓 钟咏梅 龚媛媛 王美华 汤桂花 Deng Yaqing;Chun Xiao;Zhong Yongmei;Gong Yuanyuan;Wang Meihua;Tang Guihua(PICU of Guangzhou Women and Children's Medical Center,Guangzhou 510623,China)

机构地区：[1]广州市妇女儿童医疗中心PICU,广州510623

出　　处：《中国实用护理杂志》2022年第25期1945-1949,共5页Chinese Journal of Practical Nursing

摘　　要：目的评价由护士主导的儿童导尿管拔除评估模式在PICU的应用效果。方法2020年1—5月采用便利抽样法选取广州市妇女儿童医疗中心PICU短期留置导尿管患儿100例为试验组,使用基于循证制订的儿童导尿管拔管指征评估表,每日评估导尿管的留置必要性,及时拔除不必要留置的导尿管,另回顾性收集2019年8—12月109例为对照组,医生评估并开具拔除导尿管医嘱后由责任护士拔除导尿管,记录并比较2组患儿导尿管留置天数、导尿管相关性泌尿道感染发生率、重置导尿管例数和ICU住院天数。结果试验组留置导尿管天数中位数和四分位间距为5.0(6.0)d,对照组为6.0(6.0)d,2组比较差异有统计学意义(Z=-2.01,P<0.05)。试验组导尿管相关性泌尿道感染发生率为1.000%(1/100),对照组为1.835%(2/109);试验组重置导尿管2例,对照组重置导尿管2例;试验组ICU住院天数的中位数和四分位间距为6.5(7.0)d,对照组为7.0(8.0)d,以上3项指标2组比较差异无统计学意义(χ^(2)=0.26、0.01,Z=-0.96,均P>0.05)。结论开展护士主导的儿童导尿管拔除评估模式可有效缩短PICU患儿导尿管留置天数,对降低导尿管相关性泌尿道感染发生率具有一定的临床实践意义。Objective To evaluate the application effect of the nurse-led catheter extraction assessment model for children in PICU.Methods From January to May 2020,100 children with short-term catheter in PICU of Guangzhou Women and Children Medical Center were selected by convenient sampling method as the experimental group,the need for urethral catheter indwelling was assessed daily using an evidence-based assessment scale in PICU children,and the unnecessary indwelling catheters were removed timely,and 109 children with indwelling urethral catheters from August to December 2019 were collected as the control group,the catheter was removed by the nurse on medical advice,recorded and compared days of indwelling of catheters,the incidence of patients with catheter-associated urinary tract infection,resetting of catheters and the length of stay in ICU between the two groups.Results The median and interquartile spacing of the days with indwelling catheter were 5.0(6.0)days in the experimental group and 6.0(6.0)days in the control group(Z=-2.01,P<0.05).In the experimental group,the incidence of catheter-associated urinary tract infection was 1.000 percent(1/100),and in the control group,the incidence of catheter-associated urinary tract infection was 1.835 percent(2/109);in the experimental group,2 cases of urethral catheter were reset,and in the control group,2 cases of urethral catheter were reset;the median and interquartile spacing of the length of stay in ICU was 6.5(7.0)days in the experimental group and 7.0(8.0)days in the control group.The differences of the above three indexes between the two groups were statistically significant(χ^(2)=0.26,0.01,Z=-0.96,all P>0.05).Conclusions The nurse-led catheter extraction assessment model for children can effectively shorten the catheter indwelling days for children in PICU,which has certain clinical practice significance for reducing the incidence of catheter-associated urinary tract infection.

关 键 词：护士主导 儿童 导尿管 拔除 

分 类 号：R473.72[医药卫生—护理学]