降低呼吸照護病房病患之泌尿道感染密度

Reduction of the Urinary Tract Infection Density in the Respiratory Care Ward

泌尿道感染對慢性病人而言，不僅增加身心痛苦與死亡率，醫療成本花費亦相對提升。本呼吸照護病房因泌尿道感染密度高，故成立專案小組期能降低單位泌尿道感染密度。執行期間為2009年12月至2010年12月，經現況分析後發現原因有照顧服務員對泌尿道感染認知不足與照護行為不確實、護理人員導尿技術正確率低、導尿技術監測未落實與留置導尿管照護內容繁瑣。研擬解決方案包括加強教育訓練及技術指導、修訂照顧服務員照護作業流程、設計水份補充提醒機制、擬訂導尿技術稽核計畫與留置導尿管照護查檢表。經由以上改善措施後，單位泌尿道感染密度由平均6.1‰降至2.7‰，成效顯著，期能作為相關照護單位之參考。

Urinary tract infection not only causes physical and mental suffering but it also increases mortality in chronically ill patients. It also increases medical costs. Because the incidence of urinary tract infection was much higher in our respiratory care ward than the other wards in our hospital, a project team was organized to reduce the incidence of urinary tract infection there between Dec. 2009 and Dec. 2010. Situation analysis revealed the main causes to be inadequate knowledge of urinary tract infection and uncertain care behavior in nursing aides, poor performance of the urinary catheterization technique, unsatisfactory urinary catheter monitoring, and overly complicated indwelling urinary catheter care. Based on these findings, continuing education and skill guidance were intensified, service process in nursing aides was revised, aides were reminded of the importance of fluid supplementation, and a urinary cauterization skill surveying plan and indwelling urinary catheter care checklist were developed. After the above improvement measures were implemented, the unit urinary tract infection density significantly decreased from 6.1‰ to 2.7‰. We hope these findings can be used to upgrade the quality of care in hospital-affiliated nursing units.