降低神經內科病房導尿管相關泌尿道感染密度之改善專案

Project for Reducing Urinary Tract Infection Density Associated with Urinary Catheters in the Neurology Ward

導尿管相關泌尿道感染是醫院常見院內感染，本單位2018年導尿管相關泌尿道感染密度為6.41‰，為全院居冠，引發動機。分析原因為未定期進行教育訓練、未進行導尿管置入與照護相關審核、未每日與醫療團隊討論拔除時間、未完全依照標準作業書執行導尿管置入、照顧者技能不熟練、缺乏洗手設備、未使用專屬集尿筒。經專案改善措施介入:系統性推動教育訓練計畫及課程、建立導尿管置入及Bundle care每日審核制度、建立電子交班提醒系統、拍攝導尿管置入影片、修訂導尿管置入作業標準書、改善照護相關設備。本專案於實施後已達目標其感染密度由改善前6.41‰降至1.37‰，不僅降低院內感染，亦同時降低醫療成本，提升醫療質量、照護品質及醫護人員的專業能力。

Urinary tract infections (UTIs) associated with urinary catheters are common healthcare-associated infections in hospitals. In our department, the density of UTIs associated with urinary catheters was 6.41‰in 2018, ranking the highest in the entire hospital, which prompted us to take action. The analysis identified several contributing factors, including lack of regular education and training, absence of auditing for catheter insertion and care, failure to discuss removal timing with the medical team on a daily basis, inadequate adherence to the standard operating procedures for catheter insertion, lack of proficiency among caregivers, inadequate hand hygiene facilities, and non-use of dedicated urine collection bags. To address these issues, we implemented improvement measures, including a systematic educational training program, establishment of daily auditing for catheter insertion and bundle care, implementation of an electronic handover reminder system, production of catheter insertion videos, revision of the catheter insertion operating manual, and enhancement of care-related equipment.
After the implementation of this project, the set objectives have been successfully achieved, with the infection density reduced from 6.41‰before improvement to 1.37‰. This significant reduction has not only lowered hospital-acquired infections but also resulted in reduced healthcare costs. Additionally, it has contributed to enhancing healthcare quality, patient care standards, and the professional capabilities of medical personnel.