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导尿管相关尿路感染预防指南的现状分析

Situation analysis of guidelines for prevention of catheter-associated urinary tract infections

摘要目的:对导尿管相关尿路感染预防指南进行评价,为临床导尿管相关标准化护理方案及指南实践的质量改进方案制订提供重要依据。方法检索国内外数据库和指南网,按照纳入排除标准筛选指南。描述性分析指南的名称、发表年份、发表机构、指南制定方法、参考文献数目等一般特征资料。使用指南研究与评价工具AGREE Ⅱ对纳入指南的质量进行评价。结果纳入5部指南,1部语种为中文、其他4部均为英语。质量评价结果显示5部指南清晰性领域得分最高,平均分为72%;其次分别为独立性领域(64%)、目的和范围领域(62%)、严谨性领域(53%)、应用性领域(46%);参与人员领域最差(44%)。其中,3位评价者一致认为美国疾病预防控制中心2010年发布的Guideline for Prevention of Catheter-Associated Urinary Tract Infections 2009为推荐指南,另外建议有3部可经过相应修订后使用。结论导尿管相关尿路感染预防指南质量参差不齐,临床实践中指南的确定及选择应根据方法学质量评价结果并参考临床条件、现状等最终选取。

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abstractsObjective To evaluate the guidelines for prevention of catheter-associated urinary tract infections so as to provide important bases to formulate the program of standardized nursing care related to clinical urinary catheter and quality improvements of guideline implementation .Methods Databases and guidelines network at home and abroad were searched to collect guidelines or guidance .And then, guidelines or guidance were included according to the inclusion and exclusion criterion .Besides, we descriptively analyzed the names, years of publication, institution of publication, formulation methods, reference number of guidelines and so on.Moreover, methodological quality of included guidelines was assessed according to the Appraisal of Guidelines Research and Evaluation Ⅱ ( AGREE Ⅱ) .Results A total of five guidelines were included involving one in Chinese and four in English .Quality evaluation results illustrated that the score of clarity of five guidelines was the highest ( average of 72%) , and the next was independence ( 64%) , purpose and scope (62%), rigor ( 53%), applicability ( 46%) along with the lowest ( stakeholder involvement , 44%). Moreover, three reviewers all agreed that Guideline for Prevention of Catheter-Associated Urinary Tract Infections 2009 published by Centers for Disease Control and Prevention in 2010 should be recommended to use and three guidelines could be used after being revised .Conclusions The guidelines for prevention of catheter-associated urinary tract infections are of uneven quality .Besides, how to determine and select guideline in clinical implementation should be based the evaluation results of methodological quality , clinical environment , status and so on.

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