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題名:縮短加護病患導尿管留置天數專案
書刊名:榮總護理
作者:鍾幸枝溫如玉魏仲秀
作者(外文):Ching, Hsing-chiWen, Ru-yuhWei, Chung-hu
出版日期:2004
卷期:21:1
頁次:頁78-89
主題關鍵詞:加護病患導尿管留置泌尿道感染Intensive care unitUrinary catheterizationUrinary tract infection
原始連結:連回原系統網址new window
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  • 被引用次數被引用次數:期刊(1) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:1
  • 共同引用共同引用:4
  • 點閱點閱:2
導尿管每多留置一天即會有5%泌尿道感染的機會。因此本單位成立改善小組,希望藉此縮短導尿管留置天數,降低因導尿管多留置造成的泌尿道感染率之幅度。分析病患導尿管留置超期原因為:1.醫護人員對於導尿管留置的感控知識不足。2.無導尿管留置或拔除之相關的標準作業規範,致導尿管的置放、拔除皆由負責醫師個人之認知而定。本專案運用品管手法,針對以上缺失問題,執行改善措施:1.舉辦醫護人員泌尿道感染相關的在職教育。2.制定導尿管置放或拔除的標準作業:訂定導尿管置放或拔除的時機、天數及監測方法。結果顯示:病患導尿管留置天數由原來的7.1天縮短為4.5天;發生泌尿道感染率由原來之11.6‰降低至9.8‰,下降幅度為16個百分點。而抗生素使用之藥費亦由每月平均152,000元降至44,000元,是本專案的另一效益。
Urinary tract infections associated with the indwelling urinary catheters are the most common cause of nosocomial infections. Prolonged urinary catheterization for one more day is the most important risk factor for acquisition of a urinary tract infection with a relative risk of 5 %. The goal of this project was try to shorten the date of indwelling urinary catheters in order to reduce the catheter-associated urinary tract infections (CAUTI). We found that the causes of prolonged urinary catheterization were: 1) the knowledge of infection control relevant to the urinary catheterization is insufficient, 2) Lack of the standard operation procedure regarding the insertion or removal of urinary catheterization. In order to reduce CAUTI, we therefore developed measures to improve the situation of prolonged catheterization. The measures included a on-job training program related to urinary tract infection and setting up a standard operation procedure for the routine urinary catheterization. The results revealed that the duration of urinary catheterization was significantly reduced (from 7.1 to 4.5 days, p<0.0001). The rate of CAUTI was also significantly reduced (from 11.6% to 9.8%). The monthly cost of antibiotics from CAUTI was reduced from 152,000 to 44,000 NT dollars. The later was an unexpected effect of our project. Conclusion: This study demonstrates that a simple measure instituted as part of a continuous quality improvement program significantly reduced duration of urinary catheterization, rate of CAUTI, and additional costs of antibiotics to manage CAUTI.
期刊論文
1.陳淑媛(20011000)。呼吸加護病房提早拔除導尿管措施效果之評估。彰化醫學,6(4),246-250。  延伸查詢new window
2.李淑華、張藏能、沈淑惠、黃建賢、張友馨(20010600)。某區域醫院五年院內感染資料分析。院內感染控制雜誌,11(3),159-168。  延伸查詢new window
3.Saint, S.、Lipsky, B. A.(1999)。Preventing catheter related Bacteriuria: Can we? Should we? How?。Archives of Internal Medicine,159(8),800-808。  new window
4.Sedor, J.、Mulholland, S. G.(1999)。Hospital-acquired urinary tract infections associated with the indwelling catheter。Urological Clinical North American,26(4),821-828。  new window
5.廖張京棣、陳鴻明(19901200)。[護理作業]專案改善作業簡介。長庚護理,1(2),1-14。new window  延伸查詢new window
6.Stamm, W. E.、Sacks, T. G.(1991)。Catheter-associated urinary tract infections: Epidemiology, pathogenesis, and prevention。The American Journal of Medicine,91(suppl 3B),3B65S-3B71S。  new window
7.班仁知、游文瓊(20011200)。導尿管相關泌尿道感染之預防措施。院內感染控制雜誌,11(6),382-387。  延伸查詢new window
8.簡素娥、郭國基、黃情川、林水龍(20000600)。南部某區域醫院1995至1998年院內感染資料分析。院內感染控制雜誌,10(3),165-172。  延伸查詢new window
9.嚴小燕、陳依雯、張靜美、林金絲、王志堅、陳繼祥、李正華(19971200)。神經加護中心黏質沙雷氏桿菌院內泌尿道感染群突發調查。院內感染控制雜誌,7(6),333-339。  延伸查詢new window
10.行政院衛生署(1996)。加強加護中心院內感染監測試辦計畫成果至85年6月。感染雜誌,6,146-152。  延伸查詢new window
11.Craven, D. E.、Kunches, L. M.、Lichtenbery, D. A.(1988)。Nosocomial infection and fatality in medical and surgical intensive care unit patients。Archives of Internal Medicine,148(5),1161-1168。  new window
12.Paradisi, F.、Corti, G.、Mangani, V.(1998)。Urosepsis in the critical care unit。Critical Care Clinics,14(2),165-180。  new window
13.Richard, J.、Michael, A.(2002)。Update in Nonpulmonary Critical Care。American Journal of Respiratory and Critical Care Medicine,165,1475-1479。  new window
圖書
1.李麗傳(2000)。護理管理與實務。台北:五南。  延伸查詢new window
2.Katz, J.、Green, E.(1992)。Managing Quality: A Guide to Monitoring and Evaluating Nursing Services。St. Louis:Mosby。  new window
 
 
 
 
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