提升一般內科病房導尿管照護正確性

A Project to Improve the Accuracy of Foley Catheter Care for General Medicine Ward

泌尿道感染是常見的醫療照護相關感染，每增加一天導尿管的留置，產生導尿管相關感染的風險會增加3%~10%，其併發症、死亡率及住院天數相對提高，故正確執行導尿管照護為首要課題。本單位導尿管照顧正確率為42%，2023年1~2月導尿管相關感染率為9.4‰，高於全院閾值5.55‰，專案目的為提升照顧者導尿管照護正確性以降低感染率，經問卷、實際查核及訪談，分析導因有：導尿管護理指導內容無法讓照顧者了解、護理人員無導尿管照護之教育訓練及認知不足、無稽核照顧者執行機制及未定期評估移除導尿管。專案期間透過印尼文影音教材、圖文衛教單張配合導尿模組、辦理團體護理指導、照護共識教材、每日執行查核，並與醫療團隊討論導尿管留置必要性，以提升導尿管照護正確性至100%及降低感染率至5.68‰。

While urinary tract infection is a common healthcare-related infection, indwelling urinary catheterization can lead to a 3-10% increase in the risk of infection, with increased complications, mortality, and hospitalization days. Therefore, proper implementation of foley catheter care is the primary issue. The accuracy of foley catheter care in our unit was 42%, and the catheter-related infection rate from January to February 2023 was 9.4‰. This project aimed to improve the accuracy of foley catheter care for caregivers to reduce the infection rate. We used questionnaires, observation, and inspects revealed the following causes. The cause are：lack of understanding of nursing guide care by caregivers, lack of education and training with insufficient cognition among nursing staff, lack of audit mechanism for caregivers, and failure to evaluate foley catheter removal regularly. We adopted interventions, including Indonesian audio-visual teaching materials, graphic and textual health education leaflets, catheterization modules, group nursing guidance, nursing consensus teaching materials, and daily reviews. Moreover, we discussed the timing of catheter removal with the medical team. Finally we improve the accuracy of foley catheter care to 100% and reduce the infection rate to 5.68‰.