The Evaluation of Care Bundle at Catheter-Associated Urinary Tract Infections in Intensive Care Units of a District Hospital

• Main Authors: LING,CHENG-HUA, 凌正華
• Other Authors: Yeh,Te-Feng
• Format: Others
• Language: zh-TW
• Published: 2019
• Online Access: http://ndltd.ncl.edu.tw/handle/dmutyt

碩士 === 中臺科技大學 === 醫療暨健康產業管理系碩士班 === 107 === Purpose:This study mainly discussed the trend and risk factors of catheter- associate urinary tract infection among patients using urinary catheters in the intensive care units of a district hospital in Nantou County from 2015 to 2018. It also discussed the catheter-associate urinary tract infection rate in different "catheter associated care bundle" stages, which can then provide a safe medical environment and quality of care for patients.Methods:This is a longitudinal study which patients was placed catheters in the intensive care unit from May 2015 to December 2018 were collected by the sensory control room. A total of 2,132 cases were collected. Descriptive statistics, Chi-square test and multiple logistic regression analysis were used to identify whether demographic data, hospitalization data and catheter usage data of the cases were related to catheter-associate urinary tract infection. The trend of catheter-related urinary tract infection rate in different stages of implementing "catheter associated care bundle" was also analyzed.Results:Chi-square test and multiple logistic regression analysis showed that the longer hospitalization days and the more days in the intensive care unit, as well as the use of over size 18 catheters were significantly related to catheter-associated urinary tract infection in the intensive care units. After the implementation of "catheter associated care bundle", the average infection rate decreased from 3.17‰(SD=2.61) in the preparation period to 2.33‰(SD=0.35) and 2.43‰(SD=0.54) in the execution period and the autonomous period, respectively. The average and standard deviation of infection rate decreased showed a decreasing trend of infection rate and its variability. Conclusions: The results showed that the longer the hospitalization days, the longer days in the intensive care units, the longer indwelling days of the catheter, and the larger the catheter diameter, the higher the chance of catheter-associated urinary tract infection. Therefore, reducing the hospitalization days and the days in the intensive care unit, and using catheter with a smaller diameter can decrease the risk of catheter-associated urinary tract infection. Implementing "catheter associated care bundle" has a tendency of reducing urinary tract infection rate and its variability, which is helpful to decrease catheter-associated urinary tract infection in the intensive care units.