加護病房實施「存留導尿管照護群組」之成效評價__臺灣人文及社會科學引文索引資料庫

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題名：	加護病房實施「存留導尿管照護群組」之成效評價
書刊名：	榮總護理
作者：	張美玉／王富瑩／王筱華／王凱君／張靜雯
作者(外文)：	Chang, Mei-yu／Wang, Fu-ying／Wang, Sheau-hwa／Wang, Kae-jiun／Chang, Jing-wen
出版日期：	2009
卷期：	26:4
頁次：	頁336-345
主題關鍵詞：	存留導尿管照護群組；導管相關泌尿道感染；Urinary catheter care bundle；Catheter associated urinary tract infection
原始連結：	連回原系統網址
相關次數：	被引用次數:期刊(2) 博士論文(0) 專書(0) 專書論文(0) 排除自我引用:2 共同引用:0 點閱:3

導尿管相關泌尿道感染被視為健康照護相關感染的主要來源，導尿管使用頻繁造成病人的致病性，帶來健康照護體系的財務負擔。本研究目的為檢視實施「存留導尿管照護群組」對加護病房之導尿管留置天數及導管相關泌尿道感染密度之效果及加護病房護理人員的泌尿道感染知識與無菌導尿技術分數之差異。研究設計採取不同樣本前、後測之類實驗法，於某醫學中心六個加護病房有導尿管留置病人進行收案，實驗組1301人，對照組1258人。「存留導尿管照護群組」包括實施教育訓練、無菌導尿技術示教及查核、護理人員每日查核病人之導尿管是否符合適應症，以提醒醫師儘早拔除不必要的導尿管。研究結果顯示存留導尿管照護群組顯著降低加護病房病人的導尿管留置平均天數（7.47±2.7天vs12.1±3.5天，p=.044），雖然實驗組之導管相關泌尿道感染密度低於對照組，但未達顯著差異(5.85±0.64‰ vs 6.64±0.61‰, p=.373)。經過教育訓練及技術示教，加護病房護理人員的泌尿道感染知識與正確導尿技術分數均有明顯進步。未來仍需持續執行「存留導尿管照護群組」以降低導管相關泌尿道感染。

以文找文

Catheter-associated urinary tract infections (CAUTI) are widely recognized as a major source of health care-associated infection. The objective of this study was to examine the effectiveness of the urinary catheter care bundle during of urinary catheterization and incidence density of CAUTI in ICUs. Separate pre-post samples of quasi-experimental design were executed in six adult ICUs. There were 1301 patients in the experimental group, and 1258 in the comparison group. The urinary catheter care bundle included: education program, aseptic urinary catheterization and daily assessment for removal of the unnecessary use of urinary catheter. The study results revealed that the patients in the experimental group significantly reduced the duration of urinary catheterization (7.47±2.7 days vs 12.1±3.5, p=.044), but a significant difference was not observed in incidence density of CAUTI (5.85±0.64‰ vs 6.64±0.61‰, p =.373). The scores on the urinary tract infection knowledge and urine catheterization procedure of ICU nurses were improved after introduction of educational program and skill demonstration. Further studies are needed to examine the effects of the urinary catheter care bundle on catheter associated urinary tract infection.

以文找文

期刊論文
1.	Saint, S.、Kaufman, S. R.、Thompson, M.、Rogers, M. A.、Chenoweth, C. E.(2005)。A reminder reduces urinary catheterization in hospitalized patients。Joint Commission Journal on Quality and Patient Safety，31(8)，455-462。
2.	Wald, H. L.、Ma, A.、Bratzler, D. W.、Kramer, A. M.(2008)。Indwelling urinary catheter use in the postoperative period。Archives of Surgery，143(6)，551-557。
3.	Wang, K.、Yau, K. K. W.、Lee, A. H.、Mclachlan, G. J.(2007)。Multilevel survival modeling of recurrent urinary tract infections。Computer Methods and Programs in Biomedicine，87(3)，225-229。
4.	Weinstein, R. A.(1998)。Nosocomial infection update。Emerging Infectious Diseases，4(3)，416-420。
5.	感染控制雜誌編輯部(2005)。銀合金導尿管的臨床評估。感染控制雜誌，15(2)，125-127。延伸查詢
6.	Apisarnthanarak, A.、Thongphubeth, K.、Sirinvaravong, S.、Kitkangvan, D.、Yuekyen, C.、Warachan, B.(2007)。Effectiveness of multifaceted hospitalwide quality improvement programs featuring an intervention to remove unnecessary urinary catheters at a tertiary care center in Thailand。Infection Control Hospital Epidemiology，28(7)，791-798。
7.	Burke, J. P.(2003)。Infection control: A problem for patient safety。The New England Journal of Medicine，348(7)，651-656。
8.	Crouzet, J.、Bertrand, X.、Venier, A. G.、Badoz, M.、Husson, C.、Talon, D.(2007)。Control of the duration of urinary catheterization: Impact on catheter-associated urinary tract infection。Journal of Hospital infection，67(3)，253-257。
9.	Eggimann, P.、Pittet, D.(2001)。Infection control in the ICU。Chest，120(6)，2059-2093。
10.	Goetz, A. M.、Kedzuf, S.、Wagener, M.、Muder, R. R.(1999)。Feedback to nursing staff as an intervention to reduce catheter-associated urinary tract infections。American Journal of Infection Control，27(5)，402-404。
11.	Gokula, R. R. M.、Hickne, J. A.、Smith, M. A.(2004)。Inappropriate use of urinary catheters in elderly patients at a Midwestern community teaching hospital。American Journal Infection Control，32(4)，196-199。
12.	Huang, W. C.、Wann, S. R.、Lin, S. L.、Kunin, C. M.、Kung, M. H.、Lin, C. H.(2004)。Catheter-associated urinary tract infections in intensive care units can be reduced by prompting physicians to remove unnecessary catheters。Infection Control and Hospital Epidemiology，25(11)，974-978。
13.	Jarvis, W. R.(1996)。Selected aspects of the socioeconomic impact of nosocomial infections: Morbidity, mortality, cost, and prevention。Infection Control and Hospital Epidemiology，17(6)，552-557。
14.	Klevens, R. M.、Edwards, J. R.、Richards, C. L.、Horan, T. C.、Gaynes, R. P.、Pollock, D. A.(2007)。Estimating healthcare-associated infections and deaths in U.S. hospitals, 2002。Public Health Reports，122，160-167。
15.	Loeb, M.、Hunt, D.、O'halloran, K.、Carusone, S. C.、Dafoe, N.、Walter, S. D.(2008)。Stop orders to reduce inappropriate urinary catheterization in hospitalized patients: A randomized controlled trial。Journal of General Internal Medicine，23(6)，816-820。
16.	Maki, D. G.、Tambyah, P. A.(2001)。Engineering out the risk for infection with urinary catheters。Emerging Infectious Diseases，7(2)，342-346。
17.	National Nosocomial Infections Surveillance(2004)。System report, data summary from January 1992 through June 2004, issued October 2004。American Journal of Infection Control，32，470-485。
18.	Nicolle, L. E.(2005)。Catheter-related urinary tract infection。Drugs Aging，22(8)，627-639。
19.	Reilly, L.、Sullivan, P.、Ninni, S.、Fochesto, D.、Williams, K.、Fetherman, B.(2006)。Reducing foley catheter device days in an intensive care unit, using the evidence to change practice。AACN Advanced Critical Care，17(3)，272-283。
20.	Rosenthal, V. D.、Guzman, S.、Safdar, N.(2004)。Effect of education and performance feedback on rates of catheter-associated urinary tract infection in intensive care units in Argentina。Infection Control and Hospital Epidemiology，25(1)，47-50。
21.	Rosenthal, V. D.、Maki, D. G.、Salomao, R.、Álvarez-Moreno, C. A.、Mehta, Y.、Higuera, F.(2006)。Device-associated nosocomial infections in 55 intensive care units of 8 developing countries。Annals of Internal Medicine，145(8)，582-591。
22.	Saint, S.(2000)。Clinical and economic consequences of nosocomial catheter-related bacteriuria。American Journal of Infection Control，28(1)，68-75。

學位論文
1.	林靖瑛(2004)。病人安全環境之建構--建立醫院病人安全指標系統(碩士論文)。臺北醫學大學，臺北。延伸查詢

圖書
1.	Gregory, R. J.(2007)。Psychological testing: History, principles, and Applications。Boston, Massachusetts：Pearson Education。
2.	Grol, R.、Wensing, M.、Eccles, M.(2005)。Improving patient care: The implementation of change in clinical practice。London：Elsevier。
3.	Horan, T. G.、Gaynes, R. P.(2004)。Hospital Epidemiology and infect ion Control。Philadelphia, Pennsylvania：Lippincott Williams & Wilkins。

其他
1.	Taiwan quality indicator project(20060228)。Quarterly reports，http://internationalqip.com/Reports.aspx。
2.	吳肖琪(20031231)。院內感染指標與中央健康保險局給付資料相關性分析研究，http://www.cdc.gov.tw/public/data/DOH92-DC-1040。延伸查詢
3.	Infection Control Today Editors(20050601)。Expert discusses strategies to prevent CAUTI，http://www.infectioncontrol-today.com/articles/402/402_561feat2.html。
4.	Institute for Healthcare Improvement(20060907)。What is a Bundle?，http://www.ihi.org/IHI/Topics/CriticalCare/IntensiveCare/ImprovementStories/WhatIsaBundle.htm。

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