Multi-criteria decision analysis was used to construct the intervention strategy and nursing practice of early removal of catheters in severe neurological patients
10.3760/cma.j.cn211501-20200924-03999
- VernacularTitle:多准则决策分析法构建神经重症患者早期拔除导尿管干预策略及护理实践
- Author:
Xin ZHANG
1
;
Fang LIU
;
Lichao GONG
;
Xiaoying WANG
Author Information
1. 首都医科大学宣武医院神经内科监护室，北京 100053
- Keywords:
Multi-criteria decision analysis;
Bundled intervention strategy;
Removing urinary catheters;
Neurological intensive
- From:
Chinese Journal of Practical Nursing
2021;37(19):1446-1452
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the establishment of a cluster intervention strategy by multi-criteria decision analysis (MCDA) to provide a basis for the early removal of indwelling catheters in severe neurological patients.Methods:Through literature retrieval and MCDA, the catheter cluster intervention strategy was constructed, and the expert consultation was adopted to finally form 7 item cluster intervention strategies. The convenience sampling method was used to select 122 patients with severe neurological diseases as the research objects. A total of 61 patients with indwelling catheters from November 2018 to April 2019 were selected as the control group, and routine nursing care was performed according to indwelling catheters. A total of 61 patients with indwelling catheters from May 2019 to October 2019 were selected as the intervention group to compare the success rate of removing catheters, the number of days of indent catheters and the incidence of catheter-associated urinary tract infection ( CAUTI) in the two groups, as well as to analyze the indicators related to indent catheters in the intervention group with different diagnoses. Results:CAUTI incidence, successful catheter removal rate, indwelling days of catheter in the intervention group were 39.3% (24/61), 32.79% (20/61), 17 (14,22) days, which were significantly higher than 59.0% (36/61), 8.19% (5/61), 21 (15, 27) days in the control group, and the difference was statistically significant (χ 2 values were 4.723, 11.775, Z value was -9.211, P<0.05 or 0.01); In the intervention group, stroke patients′ indwelling time of catheter were 7-20 days, and the highest success rate of removing urinary catheters 36.6% (15/41), compared with other diseases, the difference was statistically significant ( Z values were -2.448, -2.109, P<0.05). Conclusion:MCDA construction of early catheter removal strategy can significantly shorten the indwelling time of the catheter in patients with severe neurological diseases, improve the success rate of early catheter extubation, reduce the CAUTI rate, to provide evidence-based basis for clinical nursing.
