循证护理对导尿管伴随性尿路感染护理体会.docVIP

循证护理对导尿管伴随性尿路感染护理体会 　　[摘要] 目的 探讨循证护理对导尿管伴随性尿路感染的影响。 方法 将我院216例留置尿管的患者随机分成观察组（108例）和对照组（108例）。观察组运用循证护理进行插尿管及留置尿管的护理，对照组按《临床护理技术操作标准》进行插尿管和留置尿管护理。比较两组预防尿路感染的护理方法和预防措施的有效性。 结果 观察组留置尿管第1周和第2周尿路感染发生率较对照组低，但差异无统计学意义（P 0.05）；而在留置尿管第3周和第4周，观察组尿路感染发生率分别为12.04%、23.15%，对照组分别为25.93%、45.37%，观察组较对照组明显降低，差异有统计学意义（P 　　[关键词] 尿路感染；循证护理；干预；泌尿系 　　[中图分类号] R472 [文献标识码] C [文章编号] 1673-7210（2012）02（c）-0131-02 　　 　　Clinical nursing of catheter-related urinary tract infection with evidence-based nursing 　　ZHANG Zhang DAI Xuedi LAN Jun YE Jing 　　Department of Special Clinic, Dongfang Hospital of Shanghai City, Shanghai 200120, China 　　[Abstract] Objective To evaluate the influence of catheter-related urinary tract infection with evidence-based nursing. Methods 216 cases of indwelling catheter were randomly divided into observation group (108 cases) and control group (108 cases) in our hospital. The patients in observation group were given interpolating urinary with evidence-based nursing. The patients in control group were given interpolating urinary according to operating standards of clinical nursing technology. The methods of care to prevent urinary tract infection and effectiveness of preventive measures were compared in both groups. Results The incidence of urinary tract infection in observation group with the bladder of indwelling catheter in the first and the second week were lower than those of control group, but there was no significant difference (P 0.05), and the incidence of urinary tract infection in observation group were 12.04% and 23.15% in the third week and the fourth week respectively, while the incidence of control group was 25.93% and 45.37%, the difference were statistically significant (P 0.05），具有可比性。 　　1.2 方法 　　对照组予以常规护理，而观察组采用循证护理。 　　1.2.1 循证护理人员的组成 　　由课题组长和护士共同组成，首先课题组长对小组成员进行循证护理知识培训，使小组成员能掌握循证护理的基本要领，并可以在课题中实施。 　　1.2.2 循证护理的步骤 　　1.2.2.1 循证问题 尿道为无菌环境，在插管导尿的的过程中，常常出现尿路黏膜的破损，从而导致尿道黏膜屏障损伤，常常与选择尿管不当，尿管过粗易引起尿道黏膜破损，尿管过细，易出现漏尿、脱管等情况，造成尿道口细菌逆向感染。同样导尿过程中无菌观