目标性监测对ICU导尿管相关尿路感染的护理干预效果研究

Effect of targeted monitoring of infections on nursing intervention of catheter-associated urinary tract infection in ICU

目的通过对重症监护病房(ICU)导尿管相关尿路感染采取回顾性调查和目标性监测，找出感染特点及高危因素，为预防控制导尿管相关尿路感染(CA-UTI)提供科学依据。方法将2014年1月至2014年12月收住本院ICU且留置导尿管的患者818例设为对照组，进行回顾性分析；将2015年1月至2015年12月收住ICU且留置导尿管患者790例设为观察组，进行前瞻性监测，并进行评估，在监测评价基础上实施不同的护理干预。结果观察组患者尿路感染率1.95‰，对照组患者尿路感染率3.79‰，2组比较差异有统计学意义(P<0.01)；导尿管相关尿路感染与年龄、性别、基础疾病、置管天数、会阴护理及尿袋更换次数等因素密切相关，干预前后比较差异均有统计学意义(P<0.05或P<0.01)。结论通过目标性监测，前瞻性了解ICU导尿管相关尿路感染情况及危险因素，及时采取针对性干预措施，能有效降低导尿管相关尿路感染的发病率，保障医疗护理安全，值得在临床上推广。

Objective:Through retrospective investigation and objective monitoring of ICU catheter-associated urinary tract infection(CA-UTI),to find out the characteristics and risk factors of infection,and provide scientific basis for prevention and control of urinary tract infection.Methods:A retrospective analysis of818patients admitted in ICU who received indwelling catheter from Jan.2014to Dec.2014as control group.The prospective surveillance were carried out for790patients from Jan.2015to Dec.2015were enrolled in the observation group,including gender,age,basic diseases,the number of days of insertion,perineum nursing,urine bag replacement,and evaluate the corresponding intervention measures on the basis of monitoring and evaluation.Results:The observation group of patients with urinary tract infection rate was1.95‰,the control group patients with urinary tract infection rate was3.79‰,the difference was statistically significant(P<0.01);CA-UTI with gender,age,basic diseases,the number of days of insertion,perineum nursing,urine bag replacement are closely related,the difference was statistically significant(P<0.05or P<0.01)before and after the intervention.Conclusion:Through targeted monitoring,forward-looking understanding ICU CA-UTI and the high risk factors,and adjust and take corresponding intervention measures timely so as to reduce the incidence of CA-UTI and to ensure the safety of medical care.It should be introduced in clinical practice.