| 王靓,席芳,王海播,郭彦君.重症监护室导尿管留置与拔除行为规范性调查[J].上海护理,2022,22(2): |
| 重症监护室导尿管留置与拔除行为规范性调查 |
| Investigation on the behaviors of urinary catheter indwelling and removal in intensive care units |
| DOI： |
| 中文关键词: 重症 导尿管 留置 拔除 行为 |
| 英文关键词:critical care urinary catheter indwelling removal behaviors |
| 基金项目:2020年河南省中医药科学研究项目,编号：20-21ZY2305；2020年河南省医学教育研究项目,编号：Wjlx2020038 |
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| 中文摘要: |
| [目的]了解目前重症监护室导尿管留置与拔出行为是否规范。[方法]基于郑州市某三级甲等医院重症监护信息系统,对2018年1月1日至2020年1月1日入住3个重症监护病区的重症患者分析导尿管留置和拔除行为现状,并采用倾向性匹配(propensity score,PS)探讨延迟拔除导尿管对重症患者ICU住院时间、死亡和导尿管相关尿路感染(Catheter Associated Urinary Tract Infections,CAUTI)的影响。[结果]在初次留置导尿管时,24.0%的患者不符合导尿管留置指征,位居初次导尿管留置原因的第二位。9.6%患者存在不合符导尿管留置指征,但导尿管留置次数≥2次。延迟拔除导尿管的患者入住重症监护室的时间为(12.00±12.86)天,导尿管留置总时间为(12.00±12.86)天。经PS匹配后的单因素分析结果显示,延迟拔除导尿管组与未延迟拔除导尿管组在ICU住院时间、死亡和CAUTI均具有统计学差异(P＜0.05)。[结论]该院重症监护室存在未严格遵循导尿管留置指征留置导尿管和非必要性导尿管未及时拔除的问题,提示临床管理者应高度重视和加强医生和护士对导尿管留置与拔除的行为规范性,避免导尿管的过度滥用,缩短导尿管的留置时间,降低我国有限的医疗资源浪费。 |
| 英文摘要: |
| Objective:To investigate the behaviors of urinary catheter indwelling and removal in intensive care units (ICUs). Methods:Based on intensive care information system of a tertiary hospital in Zhengzhou, data related to catheter indwelling and removal of critically ill patients admitted to 3 intensive care units from January 1 in 2018 to January 1 in 2020 was filtered and analyzed. Propensity score was used to analyze the effect of the behavior of delayed catheter removal on the length of stay, death and CAUTI of critically ill patients in ICUs compared with that of critically ill patients with non-delayed catheter removal. Results:24.0% of patients with indwelling urinary catheters did not meet the indications for catheter indwelling, ranking the second reason for the initial indwelling urinary catheter. Even though 9.6% of patients with indwelling urinary catheters did not meet the indications for indwelling catheters, the number of indwelling catheters was ≥2. Patients with delayed catheter removal were admitted to the intensive care unit for (12.00±12.86) days and the total time for catheter indwelling was (12.00±12.86) days. Univariate analysis results after PS matchings showed that the delayed catheter removal group and the non-delayed catheter removal group had statistical differences in ICU hospital stay, death and CAUTI (P＜0.05). Conclusion:The clinical staff in ICUs of this hospital did not strictly follow the indications to indwell urinary catheters and to remove unnecessary urinary catheters timely, which reminds clinical managers that they should give more attention to these behavior issues and strengthen the behavior norms of clinical staff in order to avoid excessive abuse of urinary catheters, shorten the indwelling time of urinary catheters, and reduce the waste of limited medical resources in China. |
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