减少高依赖病房导尿管相关尿路感染:为期 18 个月的质量改进干预研究期

IF 1.8 Q3 INFECTIOUS DISEASES Infection Prevention in Practice Pub Date : 2024-03-24 DOI:10.1016/j.infpip.2024.100362
Waleed Abdulmotalib Mazi , Mylene Bondad , Maryam Althumali , Turki Alzahrani
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引用次数: 0

摘要

背景导尿管通常会导致导尿管相关性尿路感染(CAUTI),进一步增加发病率和死亡率。沙特阿拉伯王国高危病房(HDU)的 CAUTI 发病率数据非常有限。与美国国家医疗安全网(US-NHSN)相比,2021 年高危病房的 CAUTI 发病率是后者的六倍。目标到 2022 年底将 CAUTI 发病率降低 50%。方法从 2022 年 1 月至 2023 年 6 月在三级高危病房开展前瞻性研究。对医院实践与美国卫生保健流行病学学会/美国传染病学会(SHEA/IDSA)基本建议之间的差距进行了评估分析。在项目开始时,采用了科特(Kotter)和拉斯格伯斯(Rathgebers)的行为改变模型。采用国家战略模式对 CAUTI 进行正规教育和预防。结果尽管导尿管使用率从 0.79 显著上升至 0.94(P 值为 0.0001),但 CAUTI 的总发病率却从 7.07/1000 降至 3.57/1000(P 值为 0.0001)。捆绑式 CAUTI 预防的依从率有所提高,并保持在 90% 以上。结论:我们认为,将行为改变与 CAUTI 预防模型的 SHEA/IDSA 结合使用 18 个月后,CAUTI 发病率有所下降。
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Reducing catheter-associated urinary tract infection in high dependency unit: an eighteen-month quality improvement intervention study period

Background

The urinary catheter usually leads to a catheter-associated urinary tract infection (CAUTI) contributing to further morbidity and mortality. There is very limited data on the CAUTI incidence rate in high-dependency units (HDUs) in the Kingdom of Saudi Arabia. The institutional CAUTI incidence rate in HDU was six times higher compared to the United States National Healthcare Safety Network (US–NHSN) in 2021.

Objective

To reduce 50% CAUTI incidence rate by the end of 2022.

Method

A prospective study was conducted in tertiary HDU from January 2022 to June 2023. A gap analysis was assessed between the hospital practices and the Society Healthcare Epidemiology of America/Infectious Diseases Society of America (SHEA/IDSA) basic recommendations. The Kotter and Rathgebers' changing behavior model was applied at the beginning of the project. Formal education and prevention of CAUTI were applied using the National Strategy Model. Surveillance and statistical data analysis were carried out using US-NHSN guidelines.

Results

The overall CAUTI incidence rate declined from 7.07- to 3.57/1000 urinary catheter days despite of significant increase in the utilization ratio from 0.79 to 0.94 (P value 0.0001). The compliance rate of the bundle CAUTI prevention was improved and sustained above 90%. A CAUTI incidence rate reduction was observed following the combination of the changing behavior and SHEA/IDSA of CAUTI prevention models over 18 months.

Conclusion

We assumed the combination of the changing behavior and the prevention models for a long period is useful in reducing the CAUTI incidence rate and possibly applied to reduce other healthcare-associated infections.

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来源期刊
Infection Prevention in Practice
Infection Prevention in Practice Medicine-Public Health, Environmental and Occupational Health
CiteScore
4.80
自引率
0.00%
发文量
58
审稿时长
61 days
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