感控督导组的建立及督导实施对预防导尿管相关尿路感染的效果

Establishment of infection control supervision group and effect of supervision on prevention of urinary catheter-associated urinary tract infection

目的探讨感控督导组的建立及督导实施对预防导尿管相关尿路感染(CAUTI)的效果。方法选取2015年1月-2016年6月于空军军医大学第一附属医院神经外科重症监护室(ICU)住院的1576例留置导尿管患者为对照组,2016年7月—2018年1月入住该监护室的2051例留置导尿管患者为干预组进行感控督导,2016年7月为干预组监测期,2016年8月-2018年1月为干预期。比较干预前后对照组与干预组CAUTI的发生率及干预组监测期、干预期CAUTI预防措施及手卫生依从率变化。结果干预组监测期CAUTI预防措施中尿袋位置依从率为87.26%,干预期尿袋位置依从率为97.51%,差异有统计学意义(P<0.05),干预期其他预防措施依从率均>97%;监测期接触导尿管系统前后手卫生依从率为40.54%,干预期接触导尿管系统前后手卫生依从率为84.70%,差异有统计学意义(P<0.05)。对照组与干预组CAUTI的发生率分别为4.31%、1.75%,差异具有统计学意义(P<0.05)。结论感控督导组的建立及督导实施可有效降低神经外科ICU导尿管相关尿路感染的发生率。

OBJECTIVE To explore the establishment of infection control supervision group and observe the effect of supervision on prevention of urinary catheter-associated urinary tract infection(CAUTI).METHODS A total of 1576 patients who were hospitalized and treated with urinary catheter indwelling in intensive care unit(ICU)of the First Affiliated Hospital of Air Force Medical University from Jan 2015 to Jun 2016 were chosen as the control group,and 2051 urinary catheter indwelling patients who were hospitalized in the ICU from Jul 2016 to Jan 2018 were assigned as the intervention group,the infection control supervision was carried out.The supervision period of the intervention group was Jul 2016,the intervention period ranged between Aug 2016 and Jan 2018.The incidence of CAUTI was compared between the control group and the intervention group before and after intervention,and the compliance rates of prevention measures for CAUTI and hand hygiene of the intervention group were compared between the supervision period and the intervention period.RESULTS In terms of the prevention measures for CAUTI,the compliance rate of urine bag location of the intervention group was 87.26%during the supervision period,97.51%during the intervention period,and there was significant difference(P<0.05).The compliance rates of other prevention measures were more than 97%during the intervention period.The compliance rate of hand hygiene before and after contact with urinary catheter system was 40.54%during the supervision period,84.70%during the intervention period,and there was significant difference(P<0.05).The incidence of CAUTI was 4.31%in the control group,1.75%in the intervention group,and there was significant difference(P<0.05).CONCLUSION The establishment of infection control supervision group and supervision may effectively reduce the incidence of CAUTI in ICU patients of neurosurgery department.