2008年美国一项预防医院内尿路感染的国家研究

David

Clinical Infectious Diseases 2008;46:243–250

MAJOR ARTICLE
Preventing Hospital-Acquired Urinary Tract Infection in the United States: A National Study
美国一项预防医院内尿路感染的国家研究
Sanjay Saint,1,2,3
Christine P. Kowalski,1
Samuel R. Kaufman,2,3
Timothy P. Hofer,1,2,3
Carol A. Kauffman,1,2
Russell N. Olmsted,5
Jane Forman,1
Jane Banaszak-Holl,4
Laura Damschroder,1,2 and
Sarah L. Krein1,2

1Veterans Affairs Ann Arbor Healthcare System, 2Department of Internal Medicine, University of Michigan Medical School, 3Veterans Affairs/University of Michigan Patient Safety Enhancement Program, 4University of Michigan School of Public Health, and 5Saint Joseph Mercy Health Care System, Ann Arbor, Michigan

Received 2 July 2007; accepted 4 September 2007; electronically published 4 December 2007.



Reprints or correspondence: Dr. Sanjay Saint, Rm. 7E08, 300 NIB-Box 0429, Ann Arbor, MI 48109–0429 (saint@med.umich.edu).
Background.  Although urinary tract infection (UTI) is the most common hospital-acquired infection in the United States, to our knowledge, no national data exist describing what hospitals in the United States are doing to prevent this patient safety problem. We conducted a national study to examine the current practices used by hospitals to prevent hospital-acquired UTI.

Methods.  We mailed written surveys to infection control coordinators at a national random sample of nonfederal US hospitals with an intensive care unit and 50 hospital beds () and to all Veterans Affairs (VA) hospitals (). The survey asked about practices to prevent hospital-acquired UTI and other device-associated infections.

Results.  The response rate was 72%. Overall, 56% of hospitals did not have a system for monitoring which patients had urinary catheters placed, and 74% did not monitor catheter duration. Thirty percent of hospitals reported regularly using antimicrobial urinary catheters and portable bladder scanners; 14% used condom catheters, and 9% used catheter reminders. VA hospitals were more likely than non-VA hospitals to use portable bladder scanners (49% vs. 29%; ), condom catheters (46% vs. 12%; ), and suprapubic catheters (22% vs. 9%; ); non-VA hospitals were more likely to use antimicrobial urinary catheters (30% vs. 14%; ).

Conclusions.  Despite the strong link between urinary catheters and subsequent UTI, we found no strategy that appeared to be widely used to prevent hospital-acquired UTI. The most commonly used practices—bladder ultrasound and antimicrobial catheters—were each used in fewer than one-third of hospitals, and urinary catheter reminders, which have proven benefits, were used in <10% of US hospitals.

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linical Infectious Diseases 2008;46:243–250
MAJOR ARTICLE
Preventing Hospital-Acquired Urinary Tract Infection in the United States: A National Study
美国一项预防医院内尿路感染的国家研究 ... [/quote]
好文，谢谢David版的分享！:handshake

David

ackground.（背景）
  Although urinary tract infection (UTI) is the most common hospital-acquired infection in the United States, to our knowledge, no national data exist describing what hospitals in the United States are doing to prevent this patient safety problem.（尽管尿路感染在美国是最常见的意愿感染，但据我们所知，尚无国家级的数据描述哪些医院在做什么以保护病人的安全。） We conducted a national study to examine the current practices used by hospitals to prevent hospital-acquired UTI.（我们做了一项国家研究来调查目前各级医院预防医院获得性尿路感染的措施。）
Methods.（方法）  
We mailed written surveys to infection control coordinators at a national random sample of nonfederal US hospitals with an intensive care unit and 50 hospital beds () and to all Veterans Affairs (VA) hospitals (我们随机抽取医院，邮寄了书面的调查表给那些有ICU和床位数大于50的非联邦医院以及所有退伍军人医院的感控人员。). The survey asked about practices to prevent hospital-acquired UTI and other device-associated infections.（调查表询问了预防医院获得性尿路感染和其他器械相关感染的措施。）
Results.  结果
The response rate was 72%. Overall, 56% of hospitals did not have a system for monitoring which patients had urinary catheters placed, and 74% did not monitor catheter duration. （反馈率为72%，总体而言，56%的医院没有一个系统性的监测医院装有导尿管的病人数，74%没有监测导管使用时间。）Thirty percent of hospitals reported regularly using antimicrobial urinary catheters and portable bladder scanners; （30%报告说常规使用抗生素导管和手提式膀胱扫描仪。）14% used condom catheters, and 9% used catheter reminders.（14%使用安全套式导管，9%使用导管提示仪。） VA hospitals were more likely than non-VA hospitals to use portable bladder scanners (49% vs. 29%; ), condom catheters (46% vs. 12%; ), and suprapubic catheters (22% vs. 9%; ); （退伍军人医院比非退伍军人医院更多使用手提式膀胱扫描仪(49% vs. 29%，安全套导管46% vs. 12%，耻骨上导管22% vs. 9%）non-VA hospitals were more likely to use antimicrobial urinary catheters (30% vs. 14%; ).（非退伍军人医院（30%）比退伍军人医院（14%）更多使用抗生素包被的导管。）
Conclusions.结论  
Despite the strong link between urinary catheters and subsequent UTI, we found no strategy that appeared to be widely used to prevent hospital-acquired UTI. （尽管导尿管与尿路感染有很强的相关性，但我们发现似乎没有一个策略被广泛用于预防医院获得性尿路感染。）The most commonly used practices—bladder ultrasound and antimicrobial catheters—were each used in fewer than one-third of hospitals, and urinary catheter reminders, which have proven benefits, were used in <10% of US hospitals.（最常用的措施——膀胱超声和抗生素导管使用的医院也少于三分之一，已经证实有效的导尿管提示仪使用率更是少于10%。）

柳莹依

尽管导尿管与尿路感染有很强的相关性，但我们发现似乎没有一个策略被广泛用于预防医院获得性尿路感染。"