医疗机构实施留置导尿管护理的临床实践调查-中国护理管理.PDFVIP

特别策划·卧床患者并发症管理 Special Planning 医疗机构实施留置导尿管护理的临床 实践调查 蔡虻 刘聚源 郭红 胡力云 柳清霞 徐小菁 [ 摘 要] 目的：调查护士对留置导尿管患者的护理现况，为留置导尿管护理最 佳实践方案提供基础数据和参考。方法：采用便利抽样法，于2015 年7-9月在中 华护理学会医院感染护理专业委员会的组织下，在全国14 个省份的 96 家医疗机构 中取样；采用《医疗机构护理人员落实重点部位医院感染预防与控制临床实践调查 表》调查临床护士2200 名，收集了调查日当天3609 名留置导尿管患者的临床实践 资料。结果：尿道口清洁方面，57.2%的患者是进行2次 /天的尿道口清洁，67.4% 的患者是用碘制剂进行消毒；留取尿标本方面，29.8%的患者留取尿标本是从导尿 管直接抽取，19.8%的患者将导尿管与集尿袋的连接处断开留取，19.4%的患者从 集尿袋直接抽取，8.5% 的患者是经皮膀胱穿刺；更换尿管方面，85.3% 的患者常 规定期更换，其中41.3% 的患者每月更换一次；膀胱冲洗方面，76.8%的患者不做 定期膀胱冲洗，而进行膀胱冲洗的患者中，88.7%的患者用生理盐水进行膀胱冲洗。结论：临床护士对于留置导尿 管的护理未达到统一规范和标准；如何将最佳证据引入到临床是目前临床工作者面临的巨大挑战。 [ 关键词 ] 留置导尿；护理；现况；调查 [中图分类号] R47 [DOI] 10.3969/j.issn.1672-1756.2016.04.005 The clinical practice of indwelling urine catheter in medical clinics / CAI Meng, LIU Juyuan, GUO Hong, HU Liyun, LIU Qingxia, XU Xiaojing // Hospital Infection Management Department, Beijing Hospital, Beijing, 100730 China /// Chinese Nursing Management-2016,16(4): 452-455 [Abstract] Objectives: To study the current status of nurse’ indwelling urine catheter in China, and to provide the best evidence and the basis for best nursing practice about urinary catheter care. Methods: Using convenient sampling method, we recruited 2200 nurses from July to September, 2015 in 96 medical institutions among 14 provinces. We surveyed the status of 3609 patients with indwelling urine catheter on survey day. Results: About 57.2% patients’ meatus urinarius were cleaned twice a day. About 67.4% patients were disinfected using iodine preparation. About 29.8% patients were kept urine specimens from catheter directly with 19.8% from the joint of catheters and urine collection bags, 19.4% from the urine collection bags, and 8.5% from a percutaneous bladder biopsy. About 85.3% patients replaced urine catheter periodically