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題名：應用電腦提醒拔除導尿管機制對導尿管使用及尿路感染之影響
書刊名：護理暨健康照護研究
作者：黃萬翠／王復德／陳瑛瑛／孫淑美
作者(外文)：Huang, Wan-tsuei／Wang, Fu-der／Chen, Yin-yin／Sun, Shu-mei
出版日期：2014
卷期：10:1
頁次：頁70-77
主題關鍵詞：感染；尿路感染；電腦提醒機制；感染管制；Infections；Urinary tract infection；Computer reminder；Infection control
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(3) 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:3
  • 共同引用共同引用:3
  • 點閱點閱:27
背景：尿路感染是最常見的醫療照護相關感染部位之一，80%的醫療照護相關尿路感染與留置導尿管有關，最好的預防策略就是避免不適當使用導尿管及移除不必要之導尿管。 目的：採用「電腦提醒機制」，評值介入前後之導尿管相關尿路感染、導尿管留置天數及使用比例的差異。 方法：採回溯性追踪研究法，某醫學中心自2012年1月至6月所有留置導尿管超過24小時的病人為研究對象，4月19日起醫護人員於電腦終端機點選有導尿管留置病人時，自動出現提醒標語畫面，提醒導尿管留置天數及評估早日拔除導尿管。 結果：留置導尿管病人共8,520人次，導尿管使用比例由介入前18.05%顯著下降至16.23%(p < .001)；而導尿管留置天數由8.68略降至8.10(p = .206)，導尿管相關尿路感染則由3.32‰下降至2.62‰(p = .112)，但無統計上之顯著差異。 結論：「電腦提醒機制」提供醫療人員及早執行導尿管拔除評估，建議可利用資訊系統的提醒措施來降低導尿管使用比例。
Background: The urinary tract is the most common site of healthcare-associated infections, and 80% of urinary tract infections are attributable to urinary catheterization. Avoiding inappropriate catheter use and removing unnecessary catheters are the best preventive strategies for this type of infection. Purpose: This study evaluates the effect of using a computer-based reminder system on the rate of catheter-associated urinary tract infections, the number of catheterization days, and the use of urinary catheters. Methods: A retrospective study was performed in a medical center that instituted a computer-based reminder system on April 19th, 2012. All patients fitted with indwelling urinary catheters for more than 24 hours were recruited as participants during the period January to June 2012. The system activates when the catheterization patient’s name is selected. Reminders that pop up automatically provide current data on number of catheterization days and assess the potential for early catheter removal. Results: A total of 8520 patients were recruited. The utilization rate of indwelling urinary catheters decreased significantly from 18.05% before the intervention to 16.23% afterward (p < .001); the duration of catheterization shortened from 8.68 days to 8.10 days (p = .206); and the rate of catheter-associated urinary tract infections decreased from 3.32‰ to 2.62‰ (p = .112), there’s no statistically significant difference. Conclusion: The computer reminder system helps physicians and nurses keep accurate track of indwelling catheters and remove them as soon as possible. The results of this study suggest that this system is an effective approach to reducing the duration of indwelling urinary catheter use for patients.
期刊論文
1.Bhatia, N.、Daga, M. K.、Garg, S.、Prakash, S. K.(2010)。Urinary catheterization in medical wards。Journal of Global Infectious Diseases，2(2)，83-90。  new window
2.Apisarnthanarak, A.、Rutjanawech, S.、Wichansawakun, S.、Ratanabunjerdkul, H.、Patthranitima, P.、Thongphubeth, K.(2007)。Initial inappropriate urinary catheters use in a tertiary-care center: Incidence, risk factors, and outcomes。American Journal of InfectionControl，35(9)，594-599。  new window
3.Talaat, M.、Hafez, S.、Saied, T.、Elfeky, R.、EIShoubary, W.、Pimentel, G.(2010)。Surveillance of catheter-associated urinary tract infection in 4 intensive care units at Alexandria university hospitals in Egypt。American Journal of Infection Control，38(3)，222-228。  new window
4.Adukauskiene, D.、Kinderyte, A.、Tarasevicius, R.、Vitkauskiene, A.(2006)。Etiology, risk factors, and outcome of urinary tract infection。Medicina (Kaunas)，42(10)，805-809。  new window
5.Apisarnthanarak, A.、Thongphubeth, K.、Sirinvaravong, S.、Kitkangvan, D.、Yuekyen, C.、Warachan, B.、Fraser, V. J.(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 and Hospital Epidemiology，28(7)，791-798。  new window
6.Blodgett, T. J.(2009)。Reminder systems to reduce the duration of indwelling urinary catheters: A narrative review。Uro- logic Nursing，29(5)，369-378。  new window
7.Chant, C.、Smith, O. M.、Marshall, J. C.、Friedrich, J. O.(2011)。Relationship of catheter-associated urinary tract infection to mortality and length of stay in critically ill patients: A systematic review and meta-analysis of observational studies。Critical Care Medicine，39(5)，1167-1173。  new window
8.Chen, Y. Y.、Chi, M. M.、Chen, Y. C.、Chan, Y. J.、Chou, S. S.、Wang, F. D.(2013)。Using a criteria-based reminder to reduce use of indwelling urinary catheters and decrease urinary tract infections。American Journal of Critical Care，22(2)，105-114。  new window
9.Chen, Y. Y.、Wang, F. D.、Liu, C. Y.、Chou, P.(2009)。Incidence rate and variable cost of nosocomial infections in different types of intensive care units。Infection Control and Hospital Epidemiology，30(1)，39-46。  new window
10.Cornia, P. B.、Amory, J. K.、Fraser, S.、Saint, S.、Lipsky, B. A.(2003)。Computer-based order entry decreases duration of indwelling urinary catheterization in hospitalized patients。The American Journal of Medicine，114(5)，404-407。  new window
11.Horan, T. C.、Andrus, M.、Dudeck, M. A.(2008)。CDC/ NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting。American Journal of Infection Control，36(5)，309-332。  new window
12.Jaggi, N.、Sissodia, P.(2012)。Multimodal supervision programme to reduce catheter associated urinary tract infections and its analysis to enable focus on labour and cost effective infection control measures in a tertiary care hospital in India。Journal of Clinical and Diagnostic Research，6(8)，1372-1376。  new window
13.Johansen, K. L.(2012)。Importance of more judicious catheter use。Archives of Internal Medicine，172(3)，262。  new window
14.Leone, M.(2012)。Prevention of CAUTI: Simple is beautiful。The Lancet，380(9857)，1891-1892。  new window
15.Leuck, A.(2012)。Complications of foley catheters - Is infection the greatest risk。The Journal of Urology，187(5)，1662-1666。  new window
16.Meddings, J.、Rogers, M. A. M.、Macy, M.、Saint, S.(2010)。Systematic review and meta-analysis: Reminder systems to reduce catheter-associated urinary tract infections and urinary catheter use in hospitalized patients。Clinical Infectious Diseases，51(5)，550-560。  new window
17.Mourad, M.、Auerbach, A.(2012)。Improving use of the "other" catheter: Comment on "reducing inappropriate urinary catheter use。Archives of Internal Medicine，172(3)，260-261。  new window
18.Saint, S.、Chenoweth, C. E.(2003)。Biofilms and catheter- associated urinary tract infections。Infectious Disease Clinics of North America，17(2)，411-432。  new window
19.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。  new window
20.Shapiro, M.、Simchen, E.、Izraeli, S.、Sacks, T. G.(1984)。A multivariate analysis of risk factors for acquiring bac- teriuria in patients with indwelling urinary catheters for longer than 24 hours。Infection Control，5(11)，525-532。  new window
21.Titsworth, W. L.、Hester, J.、Correia, T.、Reed, R.、Williams, M.、Guin, P.(2012)。Reduction of catheter- associated urinary tract infections among patients in a neurological intensive care unit: A single institution's success。Journal of Neurosurgery，116(4)，911-920。  new window
22.Umscheid, C. A.、Mitchell, M. D.、Doshi, J. A.、Agarwal, R.、Williams, K.、Brennan, P. J.(2011)。Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs。Infection Control and Hospital Epidemiology，32(2)，101-114。  new window
23.紀美滿、陳玉枝、周幸生、陳瑛瑛(20101200)。加護病房泌尿道感染相關危險因子探討。榮總護理，27(4)，328-336。new window  延伸查詢new window
 
 
 
 
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