本文關(guān)鍵詞： 尿路感染 導(dǎo)尿管 留置導(dǎo)尿 導(dǎo)尿管相關(guān)性尿路感染 CAUTI 干預(yù) 預(yù)防 集束化 循證護(hù)理　出處：《浙江大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：研究目的： 本研究旨在基于循證構(gòu)建一套適合我國(guó)護(hù)理實(shí)際的預(yù)防導(dǎo)尿管相關(guān)性尿路感染(CAUTI)的干預(yù)策略,用于指導(dǎo)臨床護(hù)理,從而降低CAUTI的發(fā)生率,節(jié)約醫(yī)療成本,縮短住院時(shí)間,并為各級(jí)醫(yī)院進(jìn)行護(hù)理質(zhì)量評(píng)價(jià)和監(jiān)控提供參考依據(jù)。 研究方法： 本研究通過(guò)循征和德爾菲法等科研方法構(gòu)建預(yù)防CAUTI的干預(yù)策略。首先在系統(tǒng)查閱和評(píng)價(jià)國(guó)內(nèi)外文獻(xiàn)的基礎(chǔ)上,經(jīng)過(guò)專家小組討論初擬預(yù)防CAUTI的干預(yù)策略。然后采用德爾菲法進(jìn)行兩輪專家函詢,并運(yùn)用專家積極系數(shù)、權(quán)威系數(shù)、變異系數(shù)、協(xié)調(diào)系數(shù)等指標(biāo),對(duì)函詢結(jié)果進(jìn)行統(tǒng)計(jì)分析。最終基于循證構(gòu)建了適合我國(guó)護(hù)理實(shí)際的預(yù)防CAUTI的干預(yù)策略。 研究結(jié)果： 構(gòu)建了預(yù)防CAUTI的集束化干預(yù)策略,包含4個(gè)維度(評(píng)估、置管、持續(xù)關(guān)注和導(dǎo)管維護(hù)、管理和監(jiān)控)、48項(xiàng)條目(具體干預(yù)策略)、8項(xiàng)附注(對(duì)某項(xiàng)干預(yù)策略的附加說(shuō)明),并對(duì)每一條目標(biāo)注了循證等級(jí)和質(zhì)量。兩輪專家函詢的積極系數(shù)分別為94.55%和92.31%；權(quán)威系數(shù)分別為0.835和0.853。第二輪函詢后各項(xiàng)干預(yù)策略重要性的變異系數(shù)為0-19.88%,可操作性變異系數(shù)為1.42%-23.36%。第二輪函詢后重要性的和諧系數(shù)為0.301,可操作性的和諧系數(shù)為0.232。 研究結(jié)論： 基于循證構(gòu)建了一套適合我國(guó)護(hù)理實(shí)際的預(yù)防CAUTI的集束化干預(yù)策略。兩輪德爾菲專家函詢的積極系數(shù)、權(quán)威系數(shù)、變異系數(shù)、和諧系數(shù)等統(tǒng)計(jì)指標(biāo)證明研究結(jié)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.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R472

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