Abstract
ObjectiveTo observe the effect of cluster nursing based on risk management strategy in the management of urinary tract infection in patients with severe craniocerebral injury.MethodsA total of 116 patients with severe craniocerebral injury who were admitted to our hospital from March 2019 to March 2021 were included. They were divided into the control group (58 patients) and the observation group (58 patients). The control group received routine nursing care and the observation group received cluster nursing based on risk management strategy. The incidence of catheter-associated urinary tract infection (CAUTI), the results of bacterial culture on the surface of the urinary catheter, the incidence of nursing risk events, the duration of placing the urinary catheter, the length of hospital stay, and hospital costs as well as the patient satisfaction score were compared between the two groups. The knowledge, attitude, and practice scale for prevention of catheter infection and the competence evaluation scale of nurses were used to evaluate the sense-control ability and core competence of the interveners.ResultsThe total incidence of CAUTI in the observation group was (6.90%) lower than that in the control group (20.69%) (p < 0.05). The bacterial culture results on the catheter surface of patients in the observation group before and after 6 and 12 h of catheter cleaning were better than those of patients in the control group (p < 0.05). The duration of indwelling urinary catheter, hospitalization time, and hospitalization expenses of patients in the observation group were lower than those of patients in the control group (p < 0.05). The incidence rate of nursing risk events in the observation group was (1.72%) lower than that in the control group (11.86%) (p < 0.05). The overall satisfaction score of patients and the control and core ability scores of nursing staff in the observation group were higher than those in the control group (p < 0.05).ConclusionCluster nursing based on risk management strategy can effectively reduce the incidence of nursing risk events and the probability of UTI in patients with severe craniocerebral injury, shorten the duration of indwelling urinary catheter and hospitalization.
Highlights
Severe craniocerebral injury is a common disease in brain surgery, often caused by traffic accidents, falling from high altitude, and other accidents [1]
This study has shown that the implementation of cluster nursing strategy can reduce the incidence of catheter-associated urinary tract infection (CAUTI) in patients [14]
The control group received routine nursing care, while the observation group received cluster nursing based on risk management strategy
Summary
Severe craniocerebral injury is a common disease in brain surgery, often caused by traffic accidents, falling from high altitude, and other accidents [1]. Patients with severe craniocerebral injury are in critical condition and progressing rapidly They usually need to have an operation. Indwelling catheter is a commonly used invasive operation method in clinic, especially for some patients with urinary incontinence and coma. It cannot only accurately observe and record the urine volume and the urine proportion of patients with severe craniocerebral injury, and prevent surgical complications. Care of clinical nurses for indwelling urinary catheter is still based on Basic Nursing Science, but there are still differences in nursing measures such as selection of urinary catheter of different departments and materials, frequency of urine bag replacement, timing of catheter removal, and evaluation and rehabilitation of bladder function after catheter removal, which have resulted in long time of indwelling urinary catheter in some patients, increased probability of urethral injury and infection, and deepened doctor–patient contradiction [8, 9]
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