导尿管置管患者尿道口低价值护理的范围综述  

Low-value care of the urethra in patients with urinary catheter:a scoping review

作　　者：尹依依 韩柳 李学靖[1] 杨丹 孟美琪 李晶晶 张静渊 郝玉芳[1] Yin Yiyi;Han Liu;Li Xuejing;Yang Dan;Meng Meiqi;Li Jingjing;Zhang Jingyuan;Hao Yufang(School of Nursing,Beijing University of Chinese Medicine,Beijing 100029,China;Department of Geriatrics,Beijing University of Chinese Medicine Third Affiliated Hospital,Beijing 100029,China)

机构地区：[1]北京中医药大学护理学院,北京100029 [2]北京中医药大学第三附属医院老年病科,北京100029

出　　处：《中华现代护理杂志》2025年第6期824-830,共7页Chinese Journal of Modern Nursing

基　　金：全国中医药高等教育"十四五"规划2023年度教育科研课题(YB-23-48)。

摘　　要：目的系统全面地检索国内外导尿管置管患者尿道口护理的相关研究,为今后去除相关的低价值护理措施提供参考。方法采用Arksey和O'Malley范围综述方法系统检索中国知网、中国生物医学文献数据库、万方数据库、维普网、PubMed、Cochrane Library、CINAHL、Embase、Web of Science等,检索时限为建库至2024年1月1日。根据纳入、排除标准筛选文献,由2名研究者独立提取导尿管护理的部位、消毒/清洁剂种类、频率、制度规范、决定因素,其中决定因素基于理论域框架进行框架分析。结果共纳入21篇文献。尿道口低价值护理行为体现在对护理溶液的选择与指南的推荐意见差距较大,且不同医院的标准不一致。提取出13条去除尿道口低价值护理行为的策略,影响去除低价值护理行为的因素包括知识、强化、环境和资源、社会影响、个人角色和身份、结果信念和记忆、注意力与决策过程。结论未来研究者应进一步细化尿道口护理证据,针对复杂、多层次的医疗保健环境开展情景化护理,以更低的成本实现持续改进和更高质量的护理。Objective To systematically and comprehensively retrieve studies on urethra care for patients with urinary catheter at home and abroad,so as to provide a reference for removing low-value care measures in the future.MethodsArksey and O'Malley scoping review method was used to systematically search the China National Knowledge Infrastructure,China Biology Medicine disc,WanFang Data,VIP,PubMed,Cochrane Library,CINAHL,Embase,and Web of Science.The search period was from database establishment to January 1,2024.Literature was screened based on inclusion and exclusion criteria,and catheter care site,disinfection/cleaner type,frequency,institutional norms,and determinants were independently extracted by two researchers,where determinants were framed based on the theoretical domains framework.ResultsA total of 21 papers were included.Urethra low-value care measures were reflected in the selection of nursing solutions that differed significantly from guideline recommendations and were inconsistently standardized across hospitals.Thirteen strategies were proposed to remove urethra low-value care measures.Factors that influenced the removal of low-value care behaviors included knowledge,reinforcement,environment and resources,social influences,personal roles and identities,outcome beliefs and memories,and attention and decision-making processes.ConclusionsFuture researchers should further refine the evidence on urethra care and develop contextualized care for complex,multilevel healthcare settings to achieve continuous improvement and high quality care at low cost.

关 键 词：综述 循证护理 导尿管 低价值护理 尿道口护理 消毒 

分 类 号：R472[医药卫生—护理学]