Prevention of hospital infections proper care of urinary catheter

Bolnička infekcija jest svaka infekcija zdrave osobe ili svaka infekcija bolesnika koja se javlja nezavisno o primarnom oboljenju, za koju se utvrdi da je do nje došlo kao posljedica dijagnostike, liječenja ili skrbi, a razvije se tijekom liječenja i skrbi, nakon dijagnostičkog ili terapijskog postupka i otpusta iz bolnice/pružatelja usluga socijalne skrbi u nekom određenom vremenskom periodu. Veća mogućnost pojave takve infekcije je kod male djece, starijih osoba, imunokompromitiranih osoba, kroničnih i kirurških bolesnika, a uzročnici mogu biti gotovo svi mikroorganizmi: bakterije, virusi, gljivice i paraziti. Najčešće bolničke infekcije su infekcije mokraćnog sustava, a glavni rizični čimbenik za njihov nastanak je kateterizacija. Kateterizacija mokraćnog mjehura je manji kirurški zahvat tijekom kojeg se urinarni kateter uvodi u mokraćni mjehur kroz uretru radi ispražnjavanja mokraće. Posljedice kateterizacije, tj. infekcije mokraćnog sustava ubrajaju se u najčešće infekcije i tako čine 40% svih infekcija koje su povezane sa zdravstvenom skrbi. Broj bolesnika s urinarnim kateterom svakim danom sve više raste i s toga je potrebno kateterizaciju mokraćnog mjehura izvoditi po suvremenim preporukama i na standardizirani način jer i najmanja pogreška dovodi do neželjenih posljedica koje mogu dovesti i do letalnog završetka. Ključ prevencije je edukacija bolesnika s urinarnim kateterom kako bi se znali nositi sa poteškoćama u svakodnevnom životu i time smanjiti rizik za nastanak infekcije. Kod bolesnika koji imaju urinarni kateter važno je svakodnevno provjeravati kateter i drenažni sustav i dokumentirati. Potrebno je izbjegavati pretjerano rukovanje kateterom jer se s time povećava rizik od pojave infekcije. Rutinska promjena katetera, ispiranje katetera i mijenjanje urinarne vrećice, te preventivno korištenje antibiotika pokazali su neučinkovitost i više se ne preporučuju. Najbolja moguća prevencija urinarnih infekcija jest izbjegavanje uvađanja urinarnog katetera, ali ukoliko to nije moguće potrebno je vađenje katetera čim prestane vrijediti neka od indikacija.A nosocomial infection is any infection of a healthy or an ill person that occurs independently of the primary illness. For that sort of infection it is necessary to determine whether it is a result of a diagnosis, treatment or medical care, whether it can develop during a medical treatment or care, after a diagnostic or therapeutic procedure and a hospital/a social welfare provider in a specific period of time. At a higher risk of attaining such an infection are children, elderly people, people with an impaired immune system, chronically ill patients and surgical patients. The cause of an infection can be almost any microorganism: bacteria, viruses, funghi and parasites. The most common hospital infections are urinary tract infections and the main risk factor for its occurrence is catheterisation. The catheterisation of the urinary bladder is a minor surgical procedure during which the urinary catheter is inserted into the bladder through the urethra in order to empty the bladder. The effects of catheterisation, i.e. urinary tract infection are the most common type of infection and therefore make up to 40% of all healthcare infections. The number of patients with urinary catheters is on the rise daily. Therefore, it is needed to perform the catheterization by standard recommendations and in a standard way, because even the slightest mistake leads to unwanted consequences that could even lead to a lethal end. The key of prevention is the education of patients with urinary catheters, so that they could know how to cope with difficulties in everyday life and thereby lower the risk of infections. In patients with urinary catheters, it is important to check the catheter and the drainage system, and document it daily. Excessive catheter handling should be avoided as this increases the risk of infection. A routine catheter change, catheter rinse and changing the drainage bag, as well as using antibiotics as a measure of prevention have shown inefficiency and are not recommended any more. The most effective prevention of urinary tract infections is to avoid inserting the urinary catheter, however if that is not possible, it is important to remove the catheter if any of the indications are no longer present