應用PRECEDE模式降低導尿管相關之泌尿道感染密度

Decreasing the Density of Urinary Tract Infection-Related Urinary Catheter Incidences by Using the PRECEDE Model

10.6692/KJN.202112_38(3).0003

蔡亞芸(Ya-Yun Tsai)；陳雁梅(Yan-Mei Chen)；謝佩珊(Pei-Shan Hsieh)；許晴茹(Qing-Ru Xu)；劉月敏(Yueh-Min Liu)

衛生教育診斷評價模式 ； 泌尿道感染 ； PRECEDE model ； Urinary tract infection

高雄護理雜誌

38卷3期（2021 / 12 / 01）

22 - 35

繁體中文

本專案旨在降低導尿管相關之泌尿道感染密度，分析主要原因爲：護理人員及照顧服務員留置導尿管照護認知不足、執行留置導尿管照護指引措施遵從性不足。本專案藉由衛生教育診斷評價（Predisposing, Reinforcing and Enabling Constructs in Educational Diagnosis and Evaluation, PRECEDE）模式有三個因子包括：（一）前置因子（二）增強因子（三）促成因子，進行導尿管相關之泌尿道感染的評估，以作為執行專案計畫推動介入策略之參考。經過舉辦相關在職教育訓練、成立稽核小組、宣導改善方案及導尿管查核表、實施獎勵辦法。單位導尿管相關之泌尿道感染密度降至7‰以下，達到專案改善目的。不僅提升導尿管之泌尿道照護執行的正確性，進而增進病人安全。

The project aims to improve the density of urinary tract infection-related catheter incidences in the clinical nursing units. According to the report from the team members, inadequate awareness of indwelling catheter care of registered nurse and attendants was discovered along with inadequate compliance with guidelines and measures for indwelling catheter care. The PRECEDE (Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation) model was applied, including the following: Predisposing factor, Reinforcing factor and Enabling factor to assess the status of the urinary tract infection-related catheter. According to the assessment results, a nursing intervention was proposed in order to decrease urinary tract infection. Through field education and training, setting up an audit team, publicizing the improvement plan and the urinary catheter checklist while implementing rewards, this was successfully achieved, with the density of urinary tract infections decreasing to less than 7 %, achieving the purpose of this project. The project improved not only the accuracy of urinary tract care but patient safety as well.