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首页> 外文期刊>BMJ: British medical journal >A nurse led education and direct access service for the management of urinary tract infections in children: prospective controlled trial
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A nurse led education and direct access service for the management of urinary tract infections in children: prospective controlled trial

机译：一个护士领导的教育和服务的直接访问尿路感染的管理孩子们:前瞻性对照试验

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Objectives To determine whether a nurse led education and direct access service improves the care of children with urinary tract infections. Design Prospective cluster randomised trial. Setting General practitioners in the catchment area of a UK paediatric nephrology department. Participants 88 general practices (346 general practitioners, 107 000 children). Main outcome measures Rate and quality of diagnosis of urinary tract infection, use of prophylactic antibiotics, convenience for families, and the number of infants with vesicoureteric reflux in whom renal scarring may have been prevented. Results The study practices diagnosed twice as many urinary tract infections as the control practices (6.42 v 3.45/1000 children/year; ratio 1.86, 95% confidence interval 1.42 to 2.44); nearly four times more in infants (age < 1 year) and six times more in children without specific symptoms. Diagnoses were made more robustly by study practices than by control practices; 99% v 89% of referred patients had their urine cultured and 79% v 60% had bacteriologically proved urinary tract infections (P < 0.001 for both). Overall, 294 of 312 (94%) children aged under 4 years were prescribed antibiotic prophylaxis by study doctors compared with 61 of 147 (41%) by control doctors (P < 0.001). Study families visited hospital half as much as the control families. Twice as many renal scars were identified in patients attending the study practices. Twelve study infants but no control infants had reflux without scarring. Conclusion A nurse led intervention improved the management of urinary tract infections in children, was valued by doctors and parents, and may have prevented some renal scarring.
机译：目标确定领导的一个护士教育和提高了直接访问服务照顾孩子的尿路感染。设计前瞻性集群随机试验。设置排水的全科医生英国儿科肾脏学部门的区域。参与者88通用实践(346从业者,107 000名儿童)。率和尿的诊断质量的措施呼吸道感染,预防性抗生素的使用,方便家庭的数量婴儿在人肾vesicoureteric回流疤痕可能是预防。研究实践诊断尿的两倍呼吸道感染控制实践(6.42 v3.45/1000的孩子/年;置信区间1.42 - 2.44);倍的婴儿(< 1年)和六岁倍的儿童没有特定的症状。诊断被研究更加强劲实践比控制实践;提到患者尿液培养79% v 60%有细菌尿呼吸道感染(P < 0.001)。294 312(94%) 4岁以下的儿童规定的抗生素预防研究医生与61年相比,147年(41%)的控制医生(P < 0.001)。医院的一半控制家庭。肾疤痕被确定的两倍病人参加实践学习。研究婴儿但没有控制婴儿反胃没有疤痕。干预改善泌尿系统的管理呼吸道感染孩子,被重视医生和家长,可能使部分肾疤痕。

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