自制指导册在降低ICU尿管相关尿路感染率中的应用

The application of self made guidance book in reducing ICU catheter associated urinary tract infection

目的 通过自制指导册的应用,提高护士的感染控制意识与能力,降低ICU尿管相关尿路感染（catheter associated urinary tract infection,CAUTI）率.方法 科室成立专项预防尿管相关尿路感染控制小组,通过医院院感数据网络的建立,每月统计出感染的病例,对相关感染病例分析原因,解析要因,修定有关尿管护理临床技术操作规程,细化尿管护理标准化程序,补订尿管评估表及专项尿管质量考核表等,将以上内容制定成图文并茂的流程指导册.此册纳入全科护理人员教育培训计划,相关护理操作流程考核,持续做好评估监测及质量控制等一系列措施.结果 自制指导册临床应用后,2015年组ICU患者的尿管相关尿路感染率为1.45‰,较科室2014年组全年尿路感染下降了2.39％‰.2015年组尿标本正确采集率（87.50％ vs.43.75％）、男性会阴护理正确执行率（81.25％ vs.47.92％）、每日尿管评估执行率（93.75％vs.37.50％）较2014年组明显升高,差异有统计学意义（P＜0.05）.结论 该自制指导册的建立为临床护士院感控制提供参考,起到正确指引作用,能有效降低ICU尿管相关尿路感染率.

Objective To improve the awareness and ability of nurses＆#39; infection control and reduce the rate of ICU catheter associated urinary tract infection through the application of self-made guidance book.Methods We set up a special control group to prevent urinary catheter associated urinary tract infection in our department.By establishing nosocomial infection data network,monthly counting up infection cases,we analyzed relating cases of infection,revised the technical operation rules of catheter clinical nursing,refined the standardized program of catheter nursing and supplemented catheter evaluation form and special catheter quality assessment sheets.Then we made a process guidebook containing above formulation illustrated which was included in the general staff education and training programs and related nursing operation process assessment for a lasting good job in the assessment of monitoring and quality control and such a series of measures.Results After using the self-made guidebook in clinic,the infection rate of ICU patients with catheter associated urinary tract in 2015 was 1.45‰,which dropped 2.39‰ than the data in 2014.What also improved nurses＆#39; compliance with daily urinary catheter assessment,the correct collection of urine specimens and the standard of perineal care.Meanwhile clinical skills quality assessment was significantly higher,which ensured the safety of patients.Conclusion The establishment of the self-made guidebook can provide reference for controlling nosocomial infection,and it can effectively reduce the rate of ICU catheter associated urinary tract infection.