提升某外科病房病人導尿管照護正確率

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

陳曉芬(Hsiao-Fen Chen)；張秋媛(Chiu-Yuan Chang)；姜美夙(Mei-Su Chiang)；林姿秀(Tzu-Hsiu Lin)；黃淑娟(Shu-Chuan Huang)；郭美玲(Mei-Ling Kao)

泌尿道感染 ； 留置導尿管照護 ； 活動式掛勾 ； Foley care ； movable hook ； urinary tract infection

志為護理-慈濟護理雜誌

17卷5期（2018 / 10 / 01）

63 - 76

繁體中文

查詢2013年醫療感染率報表，單位泌尿道感染率達千分之1.0，高於全院平均千分之0.6，顯示降低泌尿道感染率已為首要任務，引發推動本專案動機。專案小組分析導致泌尿道感染率上升問題有：衛教指導工具不夠完善、護理人員未確實洗手、尿袋懸掛工具未符合病人個別性。經決策過程選出解決方法為：舉辦留置導尿管照護在職教育訓練、修訂導尿管照護衛教手冊、拍攝留置導尿管照護DVD影片、提供新型活動式掛勾使用。並以提升病人及照顧者執行導尿管照護正確率、對留置導尿管照護認知正確率及護理人員執行導尿管照護正確率為專案改善目標。經專案推動後留置導尿管照護正確率由73.2%提升至91.6%，且成功降低泌尿道感染率由千分之1.0至千分之0.45。現持續應用於臨床上，提供更優質的照護環境。

According to the 2013 hospital report on healthcare-associated infection, the rate of urinary tract infection (UTI) in the surgical ward was 1.0%, higher than the hospital norm of 0.6%. This project was implemented to address the high UTI in the ward. The analysis of the project team contributed the elevating UTI to the following reasons: incomplete health education tool; poor hand hygiene of the nursing staff; and failure to provide the patients with individualized foley bags toolkit. After a team discussion, the following interventions were proposed: provide on-the-job training of indwelling Foley catheter care, revise health educational leaflets, produce training DVDs of indwelling Foley catheter care, and introduce a new type of movable hook. The aim of the project was set to improve the accuracy of Foley care in the patients and the caregivers and to improve the cognition of indwelling Foley catheter care and Foley catheterization in our nursing staff. After the implementation of this project, the accuracy of Foley catheter care increased from 73.2% to 91.6% and the urinary tract infection rate reduced from 1.0 per mille to 0.45 per mille. The interventions are still applied in clinical practice to provide a quality nursing environment.

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