摘要
目的探讨重症监护病房(ICU)患者留置导尿管相关性尿路感染(CAUTI)的影响因素,评价持续质量改进对预防CAUTI发生率的效果。方法回顾性分析2014年1月-2018年6月本院ICU收治的1680例患者的临床资料。统计1680例患者的导尿管使用率及尿路感染的发生率,并分析尿路感染的影响因素。选取2018年7月-2019年12月本院ICU收治的654例患者实施持续质量改进,与实施持续质量改进前的1680例患者进行比较,比较两组患者尿路感染发生率、留置导管时间及导管使用率。结果实施持续质量改进前1680例ICU患者中共有1445例患者留置导尿,导管使用率为86.01%,其中有142例患者发生CAUTI,导尿管相关性尿路感染率为9.83%。女性(16.27%)、80~90岁(29.58%)、导尿时间10~20天(37.32%)、存在肺部疾病(37.32%)、革兰阴性菌感染(55.63%)的患者发生CAUTI的比例较高。实施持续质量改进后CAUTI发生率显著低于实施前(1.93%vs9.83%),留置导管时间及导管使用率也显著降低。结论女性、80~90岁、导尿时间10~20天、存在肺部疾病、革兰阴性菌感染是ICU患者发生CAUTI的影响因素,而持续质量改进能够预防和降低CAUTI的发生,具有重要的临床意义。
Objective To explore the influencing factors of indwelling catheter associated urinary tract infection(CAUTI)in intensive care unit(ICU)patients,and evaluate the effect of continuous quality improvement on the prevention of CAUTI.Methods A retrospective analysis of the clinical data of 1680 patients admitted to the ICU of our hospital from January 2014 to June 2018 was conducted.The utilization rate of urinary catheters and the incidence of urinary tract infection in 1680 patients were counted,and the influencing factors of urinary tract infection were analyzed.The 654 patients admitted to the ICU of our hospital from July 2018 to December 2019 were selected to conduct continuous quality improvement,compared with 1680 patients before continuous quality improvement.The incidence of urinary tract infection,the time of indwelling catheter and catheter usage rate of the two groups were compared.Results Before the implementation of continuous quality improvement,there were 1445 patients with indwelling catheterization in 1680 ICU patients,the catheter usage rate was 86.01%,of which 142 patients had CAUTI,and the catheter associated urinary tract infection rate was 9.83%.Patients who were females(16.27%),80~90 years old(29.58%),with 10~20 days catheterization time(37.32%),with lung disease(37.32%),and with gram-negative bacterial infection(55.63%)had higher proportion of CAUTI.After the implementation of continuous quality improvement,the incidence of CAUTI was significantly lower than before(1.93%vs.9.83%),and the catheter indwelling time and catheter usage rate were also significantly reduced.Conclusion Female,80~90 years old,catheterization time of 10~20 days,lung disease,and gram-negative bacterial infection are the influencing factors for the occurrence of CAUTI in ICU patients.Continuous quality improvement can prevent and reduce the occurrence of CAUTI,which is of important clinical significance.
作者
方少样
全清霞
蔡晓丹
董飞云
FANG Shao-yang;QUAN Qing-xia;CAI Xiao-dan;DONG Fei-yun(The First Affiliated Hospital of Wenzhou Medical University)
出处
《医院管理论坛》
2020年第8期65-67,35,共4页
Hospital Management Forum
基金
温州市科技局项目,编号:Y20180330。
