持续质量改进在ICU导尿管相关性尿路感染中的应用

目的通过开展ICU目标性监测,针对影响因素采取干预措施,探索降低留置尿管相关性尿路感染(CAUTI)发生率的有效方法。方法对2010年10月-2011年9月ICU留置导尿管患者在目标性监测过程中,通过建立院内监控体系,认真学习导尿管相关尿路感染预防与控制技术指南,严格执行各项制度及操作规程,加强指导、考核与督查,及时发现问题,并进行持续质量改进。结果通过一年的实时监测、改进,CAUTI感染率从2010年第四季度的16.81‰降低至2011年第一～三季度的10.85‰、10.32‰、10.28‰,呈持续下降趋势,效果显著。结论有效发挥监控组织的管理功能,切实提高各级人员对医院感染的预防控制意识,及时分析、解决发现的问题,早期干预,持续改进,可以有效地控制ICU的CAUTI发生率。

Practice of continuous quality improvement in reducing catheter-related urinary tract infections in ICU

OBJECTIVE To explore the effective measures to decrease the incidence of catheter-related urinary tract infections(CAUTI) through conducting the targeted surveillance in ICU and taking interventional measures according to the influence factors.METHODS From Oct 2010 to Sep 2011,during the process of the targeted surveillance of the patients with indwelling catheter,the nosocomial surveillance system was established.We conscientiously studied the guidelines for the prevention and control of catheter-related urinary tract infections and strictly implemented the system and rules to strengthen the guidance,assessment and supervision so as to find out the problems and perform the continuous quality improvement in a timely manner.RESULTS Through a year of real-time monitoring and improvement,the incidence rate of CAUTI decreased from 16.81‰ in the fourth quarter of 2010 to 10.85 ‰,10.32 ‰,and 10.28 ‰ of the first,second and the third quarter of 2011,showing a declining trend,the effect was significant.CONCLUSION The management function of the surveillance system should be effectively brought in full play to improve the awareness of the prevention and control of nosocomial infections in order to analyze and settle the problems;the early intervention and implementation of continuous quality improvement can contribute to the effective control of the incidence of CAUTI.