关键词: 儿童；导尿管；留置；拔除；循证实践

Abstract: Objective: To apply the best evidences of indwelling and removing of urinary catheters in children to clinical practices in order that nurses' compliance with the application of those best evidences as well as children's outcomes and finally the systematic procedure of urinary catheter usage would be improved. Methods: Databases at home and abroad were retrieved and eventually a summary of evidences and a guideline were recruited. The application model of clinical evidence proposed by JBI Evidence-based Nursing Center was adopted, including in the baseline review before application and the re-examination of effects of changes after application, the analysis of obstacles during application to find out available resources and solutions and comparison of indicators before and after application. Results: The standardized procedure of indwelling urinary catheters in PICU was established. After the application of the best evidences, 6 of the 7 indicators with poor compliance were significantly improved (P<0.01). Besides, the insertion rate of urinary catheters in PICU decreased (62.83% vs 71.07%) with the time of catheter usage shortened [(6.38±2.08) d vs (8.42±5.26) d] as well as the incidence of Catheter-Associated Urinary Tract Infection (CAUTI) (0 vs 7.23‰). The difference was statistically significant (P<0.05). Conclusion: Reminder cards and videos of standardized caring procedures for indwelling urinary catheters are developed on the basis of the best evidences for indwelling and removing of urinary catheters in children, which can help establish and perfect the systematic caring procedure and effectively standardize nurses' behavior and improve their compliance, and prevent CAUTI as well as improve children's outcomes.

Key words: children; catheter; indwelling; removing; evidence-based practice