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首页> 外文期刊>The joint commission journal on quality and patient safety >An Examination of the Barriers to and Facilitators of Implementing Nurse-Driven Protocols to Remove Indwelling Urinary Catheters in Acute Care Hospitals
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An Examination of the Barriers to and Facilitators of Implementing Nurse-Driven Protocols to Remove Indwelling Urinary Catheters in Acute Care Hospitals

机译：审查实施护士驱动的协议的障碍和促进者，以消除急性护理医院的留置尿管

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Background: Urinary catheter nurse-driven protocols (UCNDPs) for removal of indwelling urinary catheters (IUCs)can potentially prevent catheter-associated urinary tract infections (CAUTIs). However, they are used inconsistently. Theobjective of this study was to examine the barriers to and facilitators of implementation of UCNDPs in acute care hospitals.Methods: Between September 2017 and January 2019, researchers interviewed 449 frontline staff (nurses, physicians),managers, and executives from 17 US hospitals to better understand their experiences implementing, using, and overseeinguse of UCNDPs. Our semistructured interview guide included questions about management practices and policies regardingenactment of a UCNDP.Results: Although the features of UCNDPs differed across hospitals, the analysis revealed that hospitals experienced commonissues related to implementing and consistently using UCNDPs as a result of three major barriers: (1) nurse deferenceto physicians, (2) physician push-back, and (3) miscommunication about IUC removal. Interviewees also described severalimportant facilitators to help overcome these barriers: (1) training care team members to use the UCNDP, (2) discussingIUC necessity and UCNDP use during rounds, (3) reminding care team members to follow UCNDPs, and (4) developingbuy-in for UCNDP use across the hospital.Conclusion: Although UCNDPs are fundamental in efforts to reduce and prevent CAUTIs, hospitals can proactivelysupport their implementation and use by developing the skills that care team members need to enact UCNDPs when patientsmeet the clinical indications for removal, and increasing awareness about the value and importance of such protocols forreducing CAUTIs and improving patient safety.
机译：背景：用于去除留置尿道导管的尿动导管护士驱动的协议（UCNDPS）（IUC）可能会阻止导管相关的尿路感染（Cautis）。但是，它们不一致地使用。这本研究的目的是审查急性护理医院在急性护理医院实施UCNDP的障碍和促进者。方法：2017年9月至2019年1月，研究人员采访了449名前线员工（护士，医师），管理者，来自17家美国医院的管理人员更好地了解他们的经验，使用和监督使用UCNDPS。我们的半系统面试指南包括关于管理实践和政策的疑问颁布UCNDP。结果：虽然UCNDP的特征在医院的不同之处，但分析显示医院经历过常见由于三个主要障碍而与UCNDP有关的问题，并使用UCNDPS：（1）护士尊重对医生，（2）医生推回，（3）关于IUC拆除的误解。受访者也描述了几个重要的促进者帮助克服这些障碍：（1）培训护理团队成员使用UCNDP，（2）讨论IUC必需品和UCNDP在轮次期间使用，（3）提醒护理团队成员遵循UCNDP，（4）发展在医院的UCNDP使用的购买。结论：虽然UCNDPS是减少和预防含CAUTIS的努力的基础，但医院可以主动支持他们的实施和使用，通过制定护理团队成员需要在患者患有UCNDP的技能满足临床适应症，以删除，并提高对这些议定书的价值和重要性的认识减少CAUTIS并提高患者安全性。

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