[1]张彩凤,闫影影,刘素芬,等.不能自行如厕婴幼儿尿液标本非侵入性采集方法的循证实践[J].军事护理,2021,38(01):53-56.[doi:10.3969/j.issn.1008-9993.2021.01.014]
　ZHANG Caifeng,YAN Yingying,LIU Sufen,et al.Non-Invasive Urine Specimen Collection Methods for Infants and Young Children Who Are Not Toilet Trained: an Evidence-Based Practice[J].Nursing Journal Of Chinese People's Laberation Army,2021,38(01):53-56.[doi:10.3969/j.issn.1008-9993.2021.01.014]
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不能自行如厕婴幼儿尿液标本非侵入性采集方法的循证实践
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《军事护理》[ISSN:2097-1826/CN:31-3186/R]

卷:
38
期数:
2021年01期
页码:
53-56
栏目:
循证护理
出版日期:
2021-01-15

文章信息/Info

Title:
Non-Invasive Urine Specimen Collection Methods for Infants and Young Children Who Are Not Toilet Trained: an Evidence-Based Practice
文章编号:
1008-9993(2021)01-0053-05
作者:
张彩凤1; 闫影影1; 刘素芬1; 钱倩1; 余卓文2; 胡肖银1
(1.广州市妇女儿童医疗中心 呼吸科,广东 广州 510623; 2.复旦大学附属儿科医院 呼吸科,上海 201102)
Author(s):
ZHANG Caifeng1; YAN Yingying1; LIU Sufen1; QIAN Qian1; YU Zhuowen2; HU Xiaoyin1
(1.Department of Respiratory,Guangzhou Women and Children's Medical Center,Guangzhou 510623,Guangdong Province,China; 2.Department of Respiratory,Children' s Hospital of Fudan University,Shanghai 201102,China)
关键词:
婴幼儿;  尿液标本采集;  循证实践;  持续质量改进;  儿科护理
Keywords:
infant and young children;  urine specimen collection;  evidence-based practice;  continuous quality improvement;  pediatric nursing
分类号:
R473.72
DOI:
10.3969/j.issn.1008-9993.2021.01.014
文献标志码:
A
摘要:
目的 实施不能自行如厕婴幼儿尿液标本非侵入性采集方法的循证实践,并探索其对一次性采集成功率的影响。方法 遵循Joanna Briggs Institute(JBI)临床证据实践应用模式,采用基于证据的持续质量改进模式的理论框架,于2019年4-11月,以证据获取、现状审查、证据引入和效果评价等4个阶段将循证实践方案应用于不能自行如厕的婴幼儿。比较循证实践方案应用前后非侵入性采集尿液标本行为的依从性、一次性采集成功率等指标的变化。结果 循证实践项目应用了10条证据。与循证实践前相比,护士有关尿液标本非侵入性采集行为的依从性提高,一次性采集成功率提高,采集次数减少,标本污染率降低,差异均有统计学意义(均P<0.05)。结论 通过循证护理对不能如厕婴幼儿进行尿液标本采集管理,可有效提高尿路感染诊断的及时性与准确性,为非侵入性采集婴幼儿尿液标本的临床实践提供实证参考。
Abstract:
Objective To implement the evidence-based practice of non-invasive urine specimen collection for infants and young children who were not toilet trained,and explore its influence on the first attempt success rate of urine specimen collection.Methods Following the Joanna Briggs Institute(JBI)clinical evidence practice application model,this study adopted the evidence-based continuous quality improvement model as the theoretical framework.From April to November 2019,the evidence-based project was applied to infants and young children who were not toilet trained following four stages of evidence acquisition,current situation review,evidence introduction and effect evaluation.The changes of non-invasive urine specimen collection compliance,the first attempt success rate and other indicators were compared before and after the project.Results A total of 10 items of evidence were applied in the evidence-based project.After evidence implementation,the non-invasive urine specimen collection compliance and the first attempt success rate were significantly improved; the times of collection and the specimen contamination rate were significantly reduced(all P<0.05).Conclusions Application of evidence-based nursing in the management of urine specimen collection for infants and young children who are not toilet trained can effectively improve the timeliness and accuracy of urinary tract infection diagnosis.It can provide an empirical reference for the clinical practice of non-invasive urine collection for infants and young children.

参考文献/References:

[1] RADMAYR C,BOGAERT G,DOGAN H S,et al.EAU guidelines on paediatric urology[EB/OL].(2019-03-15)[2020-03-15].https://uroweb.org/guideline/paediatric-urology/.
[2] KAUFMAN J,FITZPATRICK P,TOSIF S,et al.Faster clean catch urine collection(quick-wee method)from infants:randomised controlled trial[J].BMJ,2017,357:j341.
[3] Mathew C,Ann D,Carole F,et al.Non-invasive techniques for stimulating urine production in non-toilet trained children:a systematic review[J].Emerg Med J,2020,37(3):162-169.
[4] RAY S,FORBES O.Quick-Wee is an effective technique for urine collection in infants[J].Arch Dis Child Educ Pract Ed,2018,103(5):280-281.
[5] SANGRADOR O C,TERRAZAS P A.Systematic review of the validity of urine cultures collected by sterile perineal bags[J].An Pediatr(Barc),2016,84(2):97-105.
[6] 胡玉萍,吴万云,周芳芳,等.改良式集尿袋在新生儿女婴尿液标本收集中的应用[J].护理实践与研究,2016,13(3):136-137.
[7] 周英凤,胡雁,顾莺,等.基于证据的持续质量改进模式图的构建[J].中国循证医学杂志,2017,17(5):603-606.
[8] The Joanna Briggs Institute.Checklist for systematic reviews and research syntheses[EB/OL].[2020-04-10].https://joannabriggs.org/ebp/critical_appraisal_tools.
[9] Agree Enterprise website.AGREE-II-users-manual-and-23-item-instrument-2009-update-2017.[EB/OL].[2020-04-10].https://www.agreetrust.org/.
[10]National Institute for Health and Care Excellence.Urinary tract infection in under 16s:diagnosis and management[EB/OL].(2018-10-30)[2020-04-01].https://www.nice.org.uk/search?q=Urinary+tract+infection.
[11]ROBERTS K B.Urinary tract infection:clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months[J].Pediatrics,2011,128(3):595-610.
[12]中华人民共和国卫生部.尿液标本的收集和处理指南[EB/OL].(2011-09-30)[2020-03-12].http://guide.medlive.cn/guideline/6678.
[13]LALIT B,JOAN B.Urine collection techniques in infants and children with suspected tract infection[EB/OL].(2018-12-04)[2020-03-11].https://www.uptodate.com/contents/zh-Hans/urine-collection-techniques-in-infants-and-children-with-suspected-urinary-tract-infection?
[14]The Joanna Briggs Institute.Levels of evidence and grades of recommendation working party.The Joanna Briggs Institute:supporting document for the Joanna Briggs Institute levels of evidence and grades of recommendation[EB/OL].(2019-06-27).https://joannabriggs.org/jb-i approach.html.
[15]王春青,胡雁.JBI证据预分级及证据推荐级别系统(2014版)[J].护士进修杂志,2015,30(11):964-967.
[16]American Academy of Pediatrics,Steering Committee on Quality Improvement and Management.Classifying recommendations for clinical practice guidelines[J].Pediatrics.2004,114(3):874-877.
[17]ATKINS D,BEST D,BRISS P A,et al.Grading quality of evidence and strength of recommendations[J].BMJ,2004,328(7454):1490.
[18]JANSSON U,HANSON M,HANSON E,et al.Voiding pattern in healthy children 0 to 3 years old:a longitudinal study[J].J Urol,2000,6(164):2050-2054.
[19]LABROSSE M,LEVY A,AUTMIZGUINE J,et al.Evaluation of a new strategy for clean-catch urine in infants[J].Pediatrics,2016,138(3):e20160573.
[20]TRAN A,FORTIER C,GIOVANNINI-CHAMI L,et al.Evaluation of the bladder stimulation technique to collect midstream urine in infants in a pediatric emergency department[J].PLOS ONE,2016,11(3):e152598.
[21]陈霭玲,吴晖.改良女婴尿液标本收集方法的临床效果[J].中华现代护理杂志,2012,18(11):1338-1340.
(本文编辑:陈晓英)

备注/Memo

备注/Memo:
【 收稿日期 】 2020-09-08 【 修回日期 】 2020-12-08
【 基金项目 】 广州市妇女儿童医疗中心院设教学研究重点资助项目(JY20170106)
【 作者简介 】 张彩凤,硕士,主管护师,从事儿科临床工作
【 通讯作者 】 胡肖银,电话:13922787122
更新日期/Last Update: 2021-01-15