創新策略降低導尿管相關泌尿道感染密度

Innovative Strategies to Reduce the Density of Catheter-Associated Urinary Tract Infections

本專案針對內科病房導尿管相關泌尿道感染（catheter-associated urinary tract infection, CAUTI）問題，致力於降低感染率，並提升病人安全。透過教育訓練、多國語言護理指導、手部衛生強化、標語提醒及稽核機制，提升護理師與照顧者對導尿管照護的認知與執行力，2021年本院內科病房導尿管相關泌尿道感染密度為3.8‰，故期望將感染密度降低至3.8‰以下。改善措施包含組合式照護模式，結合標準操作流程與定期監測，確保護理行為符合標準。此外，利用QR code數位學習資源，方便家屬隨時學習正確導尿管照護資訊；晨間會議與臨床討論則強化團隊合作與經驗交流，使防感染觀念深入日常護理。專案實施後，護理人員對導尿管照護標準的依從性顯著提升，病房導尿管相關泌尿道感染密度從5.6‰降至2.8‰，也提升了整體照護品質與病人安全。未來將持續優化介入措施，確保感染控制成效長期維持。

This project addressed the critical issue of catheter-associated urinary tract infections (CAUTI) within medical wards, focusing on a dedicated effort to lower infection rates and improve overall patient safety. A multifaceted intervention was implemented, encompassing comprehensive education and training, provision of multilingual nursing guidance for catheter care, reinforcement of hand hygiene practices, utilization of visual reminder signage, and the establishment of robust audit and feedback mechanisms. These strategies aimed to enhance the knowledge and adherence to correct catheter care protocols among both nursing staff and caregivers. In 2021, the CAUTI incidence density in the hospital's internal medicine wards was 3.8‰(per 1,000 catheter-days); therefore, the primary objective of this project was to reduce the incidence density to below 3.8‰. Key improvement measures included the adoption of a comprehensive care bundle, which integrated standardized operating procedures with regular performance monitoring to ensure nursing practices consistently met established benchmarks. Furthermore, QR code-based digital learning resources were introduced to offer patients' families convenient, on-demand access to accurate information regarding proper catheter care. Team collaboration and experiential learning were fostered through regular morning meetings and clinical case discussions, thereby embedding infection prevention principles deeply into daily nursing practice. Following the project's implementation, there was a significant improvement in adherence to standardized catheter care protocols among nursing personnel. Consequently, a marked decrease in the incidence of CAUTI was observed within the medical wards. Specifically, the CAUTI incidence density in the ward decreased from 5.6‰to 2.8‰per 1,000 catheter-days. These outcomes contributed to an overall enhancement in the quality of care and a strengthening of patient safety. The implemented strategies proved effective in reducing CAUTI rates and improving care standards. Future efforts will be directed towards the continuous optimization of these intervention measures to ensure the long-term sustainability of infection control achievements and maintain a high quality of patient safety.