英文摘要 |
Catheter-Associated Urinary Tract Infection (CAUTI) is one of the most common nosocomial infections in intensive care units (ICUs). CAUTI can lead to increases in both healthcare costs and length of patient hospital stays. In the ICU of the hospital in Taiwan, where the author works, the CAUTI rate was 4.02% and the use rate of urinary catheters for urinary tract problems was 78% in 2009. The purpose of this project is to reduce the infection rate among patients with retained urinary catheter by implementing evidence-based clinical nursing practice. Based on the data analysis, the causes of CAUTI included prolonged use of indwelling urinary catheter without removal, missed cleaning after each bowel movement, and inadequate nursing techniques performed for cleaning of patient perineum and indwelling urinary catheter. To solve the stated problems, a set of nursing standards for indwelling urinary catheter placement and care were developed. These standards included recording the date of indwelling urinary catheter placement following indicators for catheter removal, cleaning patient perineum right after each bowel movement, and reinforcing nursing skills regarding cleaning of patient perineum and indwelling urinary catheter. After implementation of the project from April 2010 to September 2010, the use rate of indwelling urinary catheters dropped to 58% and CAUTI rate was maintained at zero from June to August, 2010. This project improved not only nursing skills but also quality nursing care with the ultimate result of the enhancement of patient well-being. |