基于循证和德尔菲法构建导尿管维护策略的研究

Study on establishing urethral catheter maintenance strategies on the basis of evidence-based practice and Delphi method

目的构建适合我国护理实际的导尿管维护策略,用于指导护理实践,降低导尿管相关性尿路感染的发生率。方法检索国内外数据库获取原始文献,采用Johns Hopkins证据等级与质量评价方法评定文献,初拟导尿管维护策略,然后采用德尔菲法使之本土化。结果 83篇文献纳入研究,通过循证和德尔菲法构建了"及时拔除""清洁与消毒""人员素质与要求""密闭性与通畅性""固定与防逆流"5个维度、25项导尿管维护策略。结论基于循证和德尔菲法构建的导尿管维护策略具有科学性和实用性。

Objective To establish a bundle of urethral catheter maintenance strategies suitable for the nursing situation of our country ,so as to guide clinical nursing and reduce the incidence of catheter-associated urinary tract infection. Methods The preliminary maintenance strategies were established by retrieval of databases both at home and abroad and appraisal of literatures was done using Johns Hopkins evidence grade and quality evaluation meth- ods. Then the Delphi method was used to make the strategies meet our national conditions. Results A total of 83 articles were included in the study. Twenty-five catheter maintenance strategies were established under 5 dimen- sions including ＂catheter removal as early as possible＂ ＂cleaning and disinfection＂ ＂personnel quality and require- ments＂ ＂closed and unobstructed drainage＂ ＂fixation and anti-reflux＂ through evidence-based practice and Delphi method. Conclusion A bundle of urethral catheter maintenance strategies established on the basis of evidence- based practice and Delphi method is scientific and practical.