โอ้ ทำยังไงดี คุณใช้กูเกิลทรานสเลทเป็นมั้ยSpecimen Collection
U. Obtain urine samples aseptically. (Category IB)
1. If a small volume of fresh urine is needed for examination
(ie, urinalysis or culture), aspirate the urine
from the needleless sampling port with a sterile syringe/
cannula adapter after cleansing the port with a disinfectant.
(Category IB)
2. Obtain large volumes of urine for special analyses
(not culture) aseptically from the drainage bag. (Category
IB)
Spatial Separation of Catheterized Patients
V. Further research is needed on the benefit of spatial
separation of patients with urinary catheters to prevent
transmission of pathogens colonizing urinary drainage systems.
(No recommendation/unresolved issue) (Key Question
2D)
IV. Quality Improvement Programs
A. Implement quality improvement (QI) programs or
strategies to enhance appropriate use of indwelling catheters
and to reduce the risk of CAUTI based on a facility
risk assessment. (Category IB) (Key Question 2D)
The purposes of QI programs should be: (1) to assure
appropriate utilization of catheters, (2) to identify and remove
catheters that are no longer needed (eg, daily review
of their continued need), and (3) to ensure adherence to
hand hygiene and proper care of catheters. Examples of
programs that have been demonstrated to be effective
include:
1. A system of alerts or reminders to identify all patients
with urinary catheters and assess the need for
continued catheterization.
2. Guidelines and protocols for nurse-directed removal
of unnecessary urinary catheters.
3. Education and performance feedback regarding appropriate
use, hand hygiene, and catheter care.
4. Guidelines and algorithms for appropriate perioperative
catheter management, such as:
a. Procedure-specific guidelines for catheter placement
and postoperative catheter removal.
b. Protocols for management of postoperative urinary
retention, such as nurse-directed use of intermittent
catheterization and use of bladder ultrasound
scanners.
V. Administrative Infrastructure
A. Provision of guidelines
1. Provide and implement evidence-based guidelines
that address catheter use, insertion, and maintenance.
(Category IB)
a. Consider monitoring adherence to facility-based
criteria for acceptable indications for indwelling urinary
catheter use. (Category II)
B. Education and Training
1. Ensure that healthcare personnel and others who
take care of catheters are given periodic in-service training
regarding techniques and procedures for urinary
catheter insertion, maintenance, and removal. Provide
education about CAUTI, other complications of urinary
catheterization, and alternatives to indwelling catheters.
(Category IB)
2. When feasible, consider providing performance
feedback to these personnel on what proportion of catheters
they have placed meet facility-based criteria and
other aspects related to catheter care and maintenance.
(Category II)
C. Supplies
1. Ensure that supplies necessary for aseptic technique
for catheter insertion are readily available. (Category
IB)
D. System of documentation
1. Consider implementing a system for documenting
the following in the patient record: indications for catheter
insertion, date and time of catheter insertion, individual
who inserted catheter, and date and time of
catheter removal. (Category II)
a. Ensuring that documentation is accessible in the
patient record and recorded in a standard format for
data collection and quality improvement purposes is
suggested. Electronic documentation that is searchable
is preferable. (Category II)
E. Surveillance resources
1. If surveillance for CAUTI is performed, ensure that
there are sufficient trained personnel and technology
resources to support surveillance for urinary catheter
use and outcomes. (Category IB)
VI. Surveillance
A. Consider surveillance for CAUTI when indicated by
facility-based risk assessment. (Category II)
1. Identify the patient groups or units on which to
conduct surveillance based on frequency of catheter
use and potential risk of CAUTI.
B. Use standardized methodology for performing
CAUTI surveillance. (Category IB)
1. Examples of metrics that should be used for
CAUTI surveillance include:
a. Number of CAUTI per 1,000 catheter-days
b. Number of bloodstream infections secondary
to CAUTI per 1,000 catheter-days