投稿分類 防護措施

主委發表種類: 壁報

投稿標題(中): 某區域教學醫院介入Bundle策略改善加護病房留置導尿管相關感染成效探討

投稿標題(英): The investigation of using bundle intervention in indwelling urinary catheter to improve infection control in ICU in a regional teaching hospital

投稿摘要: Introduction:UTI is the most common HCAI in ICU of regional hospitals, and 90% of which is related to prolonged catheter insertion. Studies show that the number of days of catheterization is an important predictor, where each additional day of raises a 5% risk. The average duration of catheterization in our ICU is 6.7 days. By minimizing the days of urinary catheter placement, along with proper catheterization care and infection control, we hope to lower infection rate.
Materials and Methods:The flawed methods are: 1. no set time for catheter removal, 2. no standardized evaluation of catheterization prior to placement, 3. differences in when to remove catheter, and 4. no standardized monitoring system . The intervening measures include: implementing Bundle for catheterization and revising the standard procedures, 2. setting standardized pre-catheterization evaluation process, 3. establishing evaluation checklist for catheter removal, 4. administering continuous medical education sessions to raise catheter care awareness, and 5. analyzing the factors for prolonged catheterization.
Results:By following the set protocol of pre-catheterization evaluation lowered the infection rate from 12.9% to 5%. Implementation of pre-catheterization assessment decreased the risk from 16.7% to 0%. With a standardized consensus for when to remove the catheter lowered the infection rate from 9.7% to 0%. Execution of evaluation checklist lowered the risk from 8.3% to 2.5%. Data statistics also showed that the days of urinary catheter placement lowered to an average of 5.7 days. The rate of urinary catheter placement is 76.2%, as compared to 92.8% in the previous year, which is an improvement of 16.6%. The overall urinary infection was 0%, as it was 7.9% the year before.
Conclusion:By implementing UTI Bundle, the medical team not only can better assess each catheterized case, but provide an enhanced comprehensive quality care for these patients.

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