主管:国家卫生健康委员会
主办:国家卫生健康委医院管理研究所
中国科技核心期刊(中国科技论文统计源期刊)
中国科学引文数据库(CSCD)核心库期刊
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• 特别策划·卧床患者并发症管理 • 上一篇    下一篇

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   

  1. 北京医院医院感染管理处(蔡虻,刘聚源);北京中医药大学护理学院(郭红,胡力云,柳清霞,徐小菁)
  • 出版日期:2016-04-25 发布日期:2016-04-25

The clinical practice of indwelling urine catheter in medical clinics

  • Online:2016-04-25 Published:2016-04-25

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。

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 and 41.3% patients were changed once a month. About 76.8% patients did not do bladder irrigation regularly. For the patients with bladder irrigation, 88.7% of patients used saline. Conclusion: Clinical nurses didn’t achieve a unified norms and standard while caring for patients with urinary catheter. Currently, the big challenge faced by clinical nurses is how to introduce the best evidence to clinic effectively.