提升亞急性呼吸照護病房留置導尿管組合式照護正確率

Increasing the Accuracy Rate of Indwelling Foley Catheter Care Bundles at a Subacute Respiratory Care Unit

導尿管照護措施不確實將增加感染風險，甚至敗血性休克死亡。本單位2015／12／1～12／31留置導尿管組合式照護正確率僅88%，經現況分析確立問題：導尿管照護前未確實洗手、醫師未每天執行移除評估、留置導尿管組合式照護措施宣導不夠及認知正確率低、缺乏洗手與導尿管留置原因提示、尿袋引流管固定工具不足和不好用。2016／1／1～12／31運用教育及視覺記憶技巧舉辦在職教育、制定移除管路提醒卡片、利用魔鬼氈製作尿袋引流管固定工具、張貼洗手警示貼紙等方法，留置導尿管組合式照護正確率由88%提升至100%，達專案目的。結果發現醒目提示標籤能提高措施執行度，另將留置導尿管組合式照護納入人員必修課程及評值項目，可落實照護一致性。

Failure to accurately implement care bundles for a Foley catheter increases the infection risk and can even lead to septic shock and death. The accuracy rate of indwelling Foley catheter care bundles from December 1 to December 31, 2015 at the unit was only 88%. Analysis of the unit's status suggested that the causes of the low accuracy rate were failure to adequately wash hands before implementing Foley catheter care; failure to perform the removal assessment daily; insufficient training on indwelling Foley catheter care bundles, causing poor understanding; lack of reminders for hand-washing and reason of Foley catheter indwelling; and inefficient fixation of the urine bag drainage tube. From January 1 to December 31, 2016, in-service education and reminder cards for catheter removal were implemented. Velcro was used to affix the urine bag drainage tube, and hand-washing reminder signs were posted. After implementing the aforementioned measures, the accuracy rate of indwelling Foley catheter care bundles increased from 88% to 100%, achieving the project objective. Thus, reminder signs can increase the execution of bundles. Moreover, the inclusion of training on indwelling Foley catheter care bundles into the required courses and evaluations of health care personnel can achieve consistency of care.