基于循证护理构建MDT网格化导管管理模式降低导尿管感染发生率的研究  

Study on Building an MDT Grid-Based Catheter Management Model Based on Evidence-Based Care to Reduce the Incidence of Catheter Infections

作　　者：王夫侠[1] 杨敏[2] 昝金玲 刘敏[3] 周贝贝 于秀荣[5] WANG Fuxia;YANG Min;ZAN Jinling;LIU Min;ZHOU Beibei;YU Xiurong(Department of Outpatient Clinic,Zaozhuang Municipal Hospital,Zaozhuang Shandong 277100,China;Department of Critical Care Medicine,Zaozhuang Municipal Hospital,Zaozhuang Shandong 277100,China;Department of Infection Management,Zaozhuang Municipal Hospital,Zaozhuang Shandong 277100,China;Department of Hepatology;Department of Nursing,Zaozhuang Municipal Hospital,Zaozhuang Shandong 277100,China)

机构地区：[1]枣庄市立医院门诊部,山东枣庄277100 [2]枣庄市立医院重症医学科,山东枣庄277100 [3]枣庄市立医院感染管理科,山东枣庄277100 [4]枣庄市立医院肝病科,山东枣庄277100 [5]枣庄市立医院护理部,山东枣庄277100

出　　处：《中国卫生标准管理》2023年第16期149-153,共5页China Health Standard Management

基　　金：山东省医药卫生科技发展计划项目(202214050264)。

摘　　要：目的观察基于循证护理构建多学科协作(multidisciplinary treatment,MDT)网格化导管管理模式对导尿管相关尿路感染(catheter associated urinary tract infection,CAUTI)的影响。方法于2022年7—12月构建MDT网格化导管管理模式,以循证医学为依托、护理质量指标为抓手,借助品管圈质量管理工具开展CAUTI持续质量改进。结果观察组医护人员理论考核成绩高于对照组,差异有统计学意义(P<0.01);观察组每日评估执行率、尿管固定正确率、集尿袋管理正确率、会阴擦洗正确率、尿标本留取正确率均高于对照组,差异有统计学意义(P<0.01);观察组导尿管使用率和CAUTI发生率低于对照组,差异有统计学意义(P<0.05);观察者留置尿管总天数及平均留置天数短于对照组,差异有统计学意义(P<0.05)。结论基于循证医学构建MDT网格化管理模式,有效提高CAUTI集束化护理措施落实率,缩短留置尿管的时间、降低CAUTI的发生率,做到同质化管控,值得临床推广应用。Objective To observe the impact of constructing multi-disciplinary treatment(MDT)grid-based catheter management model based on evidence-based care on catheter associated urinary tract infection(CAUTI).Methods The study period was from July to December 2022,and the MDT grid-based catheter management model was constructed to carry out continuous quality improvement of CAUTI with the help of quality management tools of quality control circles,relying on evidence-based medicine for evidence-based best evidence and quality of care indicators.Results The medical staff in the observation group had higher theoretical assessment scores than those in the control group,and the difference was statistically significant(P<0.01).The performance rate of daily assessment,correct rate of urinary tube fixation,correct rate of urinary bag management,correct rate of perineal scrubbing and correct rate of urine specimen retention in the observation group were higher than those in the control group,with statistical significance(P<0.01).The utilization rate of catheter and incidence of CAUTI in observation group were lower than those in control group,and the difference was statistically significant(P<0.05).The total days and average days of indwelling urinary catheter in observers were shorter than those in control group,and the difference was statistically significant(P<0.05).Conclusion The MDT grid management model based on evidence-based medicine can effectively improve the implementation rate of CAUTI intensive care measures,shorten the time of indwelling urinary catheter,reduce the incidence of CAUTI,and achieve homogeneous control.It is worthy of clinical promotion and application.

关 键 词：循证护理 MDT 网格化 管理模式 导尿管感染发生率 质量管理 

分 类 号：R472[医药卫生—护理学]