某醫學中心降低神經內科病人導管相關泌尿道感染密度之成效

Reducing Occurrence of CatheterAssociated Urinary Tract Infection: Research at the Neurology Department of a Medical Center

導管相關泌尿道感染是醫療機構最常見的院內感染之一，病人常因泌尿道感染造成疾病惡化、延長住院天數及增加醫療成本，嚴重時甚至導致死亡。並非所有導管相關泌尿道感染密度（catheter associated urinary tract infections, CAUTI）都可以預防，但通過適當的管理，可以避免大量CAUTI發生。本研究旨在探討神經內科病房導管相關泌尿道感染密度之風險因子。在2017年4月1日至2017年10月31日經由流程改造並增修訂相關方案：如擬定導尿管照護作業流程、規劃相關教育訓練、管路移除資訊系統提示、購置超音波膀胱容量測定儀、擬定導尿管護理觀察表與製作導尿管照護海報和警示牌等。以降低神經內科病人導管相關泌尿道感染密度。導管相關泌尿道感染密度由3.8‰降至1.9‰。運用流程改造，減少反覆單次導尿的次數與時間，醫護人員執行上更加簡易及流暢，有效提昇工作成效；儘早移除導尿管，能提高病人舒適度與下床次數，幫助早日進入復健期；降低感染密度及導尿管使用率，促使病人得到更好醫療品質。 Catheter-associated urinary tract infection (CAUTI) is the most common type of hospital-acquired infection in medical institutions. Urinary tract infections worsen the condition of patients, thereby extending the length of their hospital stay and possibly leading to death. Although not all CAUTIs are preventable, appropriate management can reduce their occurrence. This study mainly discusses the risk factors for CAUTIs in neurology wards. From April 1, 2017 to October 31, 2017, the researchers adopted process reengineering to reduce the occurrence of CAUTI, lowering the rates from 3.8‰ to 1.9‰. Through process reengineering, the instances and duration of repetitive straight in-and-out catheters were reduced, thereby simplifying and streamlining the operation process of medical personnel and effectively improving their work efficiency. In addition, early removal of catheters improved patient comfort and increased instances of patients leaving their bed, thereby assisting them to enter the rehabilitation phase. By reducing the occurrence of infection and catheter usage rate, the researchers assisted patients in attaining better healthcare quality.