降低住院病人導尿管感染率

Reduction of Catheter-Associated Urinary Tract Infections in a Hospital Setting

導尿管相關泌尿道感染（Catheter-associated urinary tract infections, CAUTI）是醫療機構最常見的院內感染之一。本單位2011年1-6月的CAUTI平均值較2010年高，為有效改善CAUTI故成立專案小組。經實地觀察調查後發現本單位CAUTI發生率高的主要原因為：（1）導尿管留置天數過長、（2）導尿標準作業規範與實證文獻有落差、（3）導尿管護理技術不正確、及（4）未及時處理存留導尿管之引流順暢。經（1）建置「導尿管移除評估表」（2）依實證資料修訂導尿管照護標準文件（3）規劃CAUTI在職教育（4）進行導尿管護理技術考核（5）導尿管管路安全考核等改善對策後，CAUTI由千分之8.87，降為千分之0，有效改善本單位之CAUTI。

Catheter-associated urinary tract infection is one of the most common hospital-acquired infections (CAUTI). The CAUTI occurrence rate in the medical unit where the author worked was higher in 2011 than in 2010. To effectively lower the CAUTI occurrence rate, a project team was established. The major reasons for higher CAUTI occurrence rate were (1) the length of catheter retention was too long; (2) the operational standard of urinary catheterization was deviated from research-based literature; (3) the nursing care of indwelling urinary catheter was incorrect; (4) inappropriate handling in maintaining unobstructed drainage. The improvement measures included (1) initiation of a urinary catheter removal assessment sheet, (2) revision of the protocol based on research evidence, (3) implementation of CAUTI in-service education, (4) evaluation of nursing care skill of indwelling urinary catheter, and (5) routine examination of indwelling urinary catheters. With all above measures, the CAUTI rate reduced from 0.887(permille) to 0(permille).