一例超高龄髋部骨折患者术后预防导尿管相关尿路感染的循证护理

摘要

目的 探讨1例超高龄髋部骨折患者术后预防导尿管相关尿路感染的循证护理方案.方法 依据循证护理原则及该患者的实际病情,分析易导致尿路感染发生的原因,检索美国指南网、PUBMED、Cochrane Library、JBI循证卫生保健数据库、EBMR循证医学数据库、美国疾病预防和控制中心网站、万方数据库、中国期刊全文数据库,全面收集预防及护理老年髋部骨折留置尿管患者尿路感染的临床证据.结果 最终纳入5篇临床实践指南、10篇随机对照研究.根据最终检索结果,结合患者病情采取针对性的护理措施,包括选用抗反流集尿装置、妥善固定防逆流、选用温清水进行会阴护理、密切观察拔管指征,有效地预防了留置尿管后尿路感染的发生,改善了患者的生存质量.结论 针对超高龄髋部骨折患者留置尿管后尿路感染问题,基于循证基础的全面的评估及合理的维护能有效预防尿路感染的发生.%Objective To study the effect of evidence－based nursing on preventive urethral catheter related infection in elder with postoperative of hip fracture.Methods The clinical evidence on urethral catheter related infection in elder with postoperative of hip fracture were collected through the databases such as National Guideline Clearinghouse,PUBMED,the Cochrane Library,JBI,EBMR,Centers for Dis?ease Control and Prevention,CNKI and Wanfang Data,and analysis the reasons of urethral catheter related infection.Results Five of clinical practice guidelines and 10 of RCTs were included.Then proper nursing measures were taken in combination with patients condition,including using anti reflux urine collection device,properly fixed,warm water to carry out perineum nursing,observed exudation indication,effectively prevent the occurrence of indwelling urinary catheter related infection,so as to improve patients＇quality of life.Conclusion Comprehensive assessment and reasonable nursing measures based on evidence can effectively prevent the urinary catheter related infection in elder with post?operative of hip fracture.