集束化干预降低导尿管相关尿路感染的效果
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1.南方医科大学附属东莞市人民医院, 广东 东莞 523000;2.中山大学公共卫生学院医学统计系, 广东 广州 510080

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杜志成 E-mail: duzhch5@mail.sysu.edu.cn

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Effect of bundle intervention on reducing catheter-associated urinary tract infection
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1.Dongguan People's Hospital Affiliated to Southern Medical University, Dongguan 523000, China;2.Deparment of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China

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    摘要:

    目的 评估集束化干预措施降低导尿管相关尿路感染(CAUTI)的效果。 方法 2017年1—6月对某院留置导尿管患者进行目标性监测的基线调查(干预前期),7—12月结合PDCA(plan-do-check-act)工具找出主要原因并制定集束化干预措施(过渡期),2018年1—6月落实干预措施(干预后期),对比干预前后导尿管使用率、人均留置导尿管日数、日发病率的差异。 结果 干预后手卫生依从率、防控措施执行率、防控措施知晓率分别为81.94%、95.37%、97.98%,高于干预前的64.66%、66.31%、65.02%,干预后每日评估执行率达96.15%。CAUTI日发病率从干预前的1.71‰降至干预后的1.22‰,导尿管使用率从干预前的10.02%降至干预后的7.69%,内科系统CAUTI日发病率从干预前的3.73‰降至干预后的1.56‰,干预前后上述指标比较差异均有统计学意义(均P < 0.05)。 结论 开展CAUTI目标性监测,结合PDCA工具能发现医院感染防控的薄弱环节,为制定专项防控措施提供循证依据,落实集束化干预措施能有效降低CAUTI发病率。

    Abstract:

    Objective To evaluate the effect of bundle intervention on reducing catheter-associated urinary tract infection (CAUTI). Methods From January to June 2017, the baseline survey was conducted on targeted monitoring of patients with urinary catheterization in a hospital (pre-intervention period); from July to December, combined with plan-do-check-act (PDCA) tool, the main causes were find out and bundle intervention measures were formulated (transitional period); from January to June in 2018, intervention measures were implemented (post-intervention period), difference in urinary catheter utilization rate, average urinary catheterization days, and incidence of CAUTI per 1 000 catheter-days before and after intervention were compared. Results After intervention, compliance rate of hand hygiene, implementation rate of prevention and control measures, as well as awareness rate of prevention and control measures were 81.94%, 95.37% and 97.98% respectively, which were higher than 64.66%, 66.31% and 65.02% before the intervention, implementation rate of daily assessment reached 96.15% after intervention. Incidence of CAUTI per 1 000 urinary catheter-days decreased from 1.71‰ before intervention to 1.22‰ after intervention, catheter utilization rate dropped from 10.02% before intervention to 7.69% after intervention, incidence of CAUTI per 1 000 urinary catheter-days in internal medical wards dropped from 3.73‰ before intervention to 1.56‰ after intervention, differences between these indexes before and after intervention were all statistically significant (all P < 0.05). Conclusion CAUTI target monitoring combined with PDCA tool can identify the weak links of HAI prevention and control, provide evidence for formulating specific prevention and control measures, and implement bundle intervention measures to reduce the incidence of CAUTI effectively.

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刘厚荣,杜志成.集束化干预降低导尿管相关尿路感染的效果[J]. 中国感染控制杂志,2021,(4):340-345. DOI:10.12138/j. issn.1671-9638.20216163.
Hou-rong LIU, Zhi-cheng DU. Effect of bundle intervention on reducing catheter-associated urinary tract infection[J]. Chin J Infect Control, 2021,(4):340-345. DOI:10.12138/j. issn.1671-9638.20216163.

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  • 收稿日期:2020-09-02
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  • 在线发布日期: 2021-07-26
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