基于循证构建预防导尿管相关性尿路感染的干预策略的研究

发布时间：2018-03-01 18:50

本文关键词： 尿路感染导尿管留置导尿导尿管相关性尿路感染 CAUTI 干预预防集束化循证护理　出处：《浙江大学》2014年硕士论文　论文类型：学位论文

【摘要】：研究目的：本研究旨在基于循证构建一套适合我国护理实际的预防导尿管相关性尿路感染(CAUTI)的干预策略,用于指导临床护理,从而降低CAUTI的发生率,节约医疗成本,缩短住院时间,并为各级医院进行护理质量评价和监控提供参考依据。研究方法：本研究通过循征和德尔菲法等科研方法构建预防CAUTI的干预策略。首先在系统查阅和评价国内外文献的基础上,经过专家小组讨论初拟预防CAUTI的干预策略。然后采用德尔菲法进行两轮专家函询,并运用专家积极系数、权威系数、变异系数、协调系数等指标,对函询结果进行统计分析。最终基于循证构建了适合我国护理实际的预防CAUTI的干预策略。研究结果：构建了预防CAUTI的集束化干预策略,包含4个维度(评估、置管、持续关注和导管维护、管理和监控)、48项条目(具体干预策略)、8项附注(对某项干预策略的附加说明),并对每一条目标注了循证等级和质量。两轮专家函询的积极系数分别为94.55%和92.31%；权威系数分别为0.835和0.853。第二轮函询后各项干预策略重要性的变异系数为0-19.88%,可操作性变异系数为1.42%-23.36%。第二轮函询后重要性的和谐系数为0.301,可操作性的和谐系数为0.232。研究结论：基于循证构建了一套适合我国护理实际的预防CAUTI的集束化干预策略。两轮德尔菲专家函询的积极系数、权威系数、变异系数、和谐系数等统计指标证明研究结果可靠。
[Abstract]:Objectives of the study:. The purpose of this study was to establish a set of intervention strategies based on evidence to prevent urinary catheter associated urinary tract infection (CaUTI) in order to guide clinical nursing, so as to reduce the incidence of CAUTI, save medical costs and shorten hospital stay. It also provides reference basis for nursing quality evaluation and monitoring in hospitals at all levels. Research methods:. In this study, the intervention strategies for preventing CAUTI were constructed by means of evidence-based and Delphi methods. Firstly, based on the systematic review and evaluation of domestic and foreign literature, The intervention strategy for the prevention of CAUTI was discussed by the expert group. Then two rounds of expert inquiry were conducted by Delphi method, and the positive coefficient, authority coefficient, variation coefficient, coordination coefficient and so on were used, such as expert positive coefficient, authority coefficient, variation coefficient, coordination coefficient and so on. The results of the letter were statistically analyzed. Finally, the intervention strategy of prevention of CAUTI was constructed based on evidence. Results of the study:. A cluster intervention strategy for the prevention of CAUTI was constructed, which included four dimensions (evaluation, catheterization, continuous attention and catheter maintenance). Management and monitoring of 48 items (8 notes to a specific intervention strategy (annotated to a certain intervention strategy, and an Evidence-based rating and quality note on each objective). The positive coefficients of the two rounds of expert letters were 94.55% and 92.31, respectively; The coefficients were 0.835 and 0.853, respectively. The coefficient of variation of the importance of intervention strategies was 0-19.88, the coefficient of operational variation was 1.42-23.36, the harmony coefficient of importance after the second round was 0.301, and the coefficient of operational harmony was 0.232. The study concluded that:. Based on the evidence, a set of cluster intervention strategies for the prevention of CAUTI was constructed. The positive coefficient, authority coefficient, variation coefficient, harmony coefficient and so on of the two rounds of Delphi expert letter showed that the results of the study were reliable.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R472

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