THE IMPORTANCE OF THENURSING CARE TOWARDS PREVENTION OF INFECTIONS IN PATIENTS WITH URINARY CATHETER

Infekcija je biološki proces pri kojem dolazi do opće ili lokalne reakcije prilikom ulaska štetnih mikroorganizama i njihovog razmnožavanja u tijelu domaćina Urinarne infekcije povezane sa urinarnim kateterom su najčešće bolničke infekcije te predstavljaju ozbiljan javnozdravstveni problem od kojih godišnje oboli oko 150 milijuna ljudi. Prema studijama prevalencije kateterizirano je 17,5% bolesnika u Europi i 23,6% bolesnika u Sjedinjenim Američkim državama. Jednokratna kateterizacija uzrokuje infekciju urinarnog trakta u samo 1% bolesnika, dok se unutar pet dana od postavljanja urinarnog katetera bakteriurija javlja u 10 - 27% hospitaliziranih osoba. Medicinske sestre imaju osobitu važnost u prevenciji urinarnih infekcija kod bolesnika sa urinarnim kateterom jer mnoge preventivne intervencije spadaju u njihov djelokrug rada. Sam postupak urinarne kateterizacije se mora provoditi aseptičnom tehnikom koja se treba koristiti tijekom cijelog postupka, a sav pribor mora biti sterilan te jednokratan. Za uvođenje urinarnog katetera medicinska sestra treba pripremiti bolesnika, pribor, prostoriju i sebe. Važno je redovito provođenje higijene ruku osoblja, a sve u svrhu prevencije infekcije. Nakon što se izabere adekvatna veličina katetera i materijal, medicinska sestra treba brinuti o svakodnevnom nadzoru nad urinarnim kateterom, drenažnim sustavom, toaletom meatusa te skrbiti o bolesniku. Urinarni kateter je potrebno postaviti preko natkoljenice osobe, kako ne bih došlo do pritiska cijevi i spriječio protok mokraće kroz cijev. Uzorke urina za dijagnostičke pretrage kod uvedenog katetera potrebno je uzimati aseptičnom tehnikom. Cilj svakodnevnog nadziranja je da se dnevno revidira potreba za urinarnim kateterom. Ako urinarni kateter više nije potreban, treba ga odstraniti. Najčešći problemi koji se pojavljuju kod bolesnika koji imaju urinarni kateter su visok rizik za infekciju te smanjena mogućnost brige o sebi – eliminacija. Danas postupak prevencije, koji je, osim što obuhvaća potreban pribor za kateterizaciju i rukovanje, proširen i na cjelovit bolesniku usmjeren pristup. Od iznimne je važnosti provođenje edukacije osoblja, a osobito novozaposlenog kadra te podučavanje pacijenta i njegove obitelji.Infection is a biological process that occurs when pathogenic microorganisms enter and multiply in the host's body, causing a local or general reaction. Urinary catheter-related urinary tract infections are the most common nosocomial infections and represent a serious public health problem that affects approximately 150 million people annually. According to prevalence studies, 17.5% of patients in Europe and 23.6% of patients in the United States were catheterized. One-time catheterization causes urinary tract infection in only 1% of patients, while within five days of placement of the urinary catheter bacteriuria occurs in 10 - 27% of hospitalized persons. Nurses are of particular importance in the prevention of urinary tract infections in patients with a urinary catheter because many preventive interventions fall within their remit. The urinary catheterization procedure itself must be performed by an aseptic technique, which should be used throughout the procedure, and all accessories must be sterile and disposable. For the introduction of a urinary catheter, the nurse should prepare the patient, accessories, room, and herself. It is important to carry out regular hand hygiene of the staff, all for infection prevention. Once the appropriate catheter size and material has been selected, the nurse should take care of the daily monitoring of the urinary catheter, drainage system, meat toilet, and care for the patient. A urinary catheter should be placed over a person’s thigh, so as not to put pressure on the tube and prevent the flow of urine through the tube. Urine samples for diagnostic tests with the introduced catheter should be taken by an aseptic technique. The goal of daily monitoring is to review the need for a urinary catheter daily. If a urinary catheter is no longer needed, it should be removed. The most common problems that occur in patients who have a urinary catheter are a high risk of infection and a reduced ability to take care of themselves - elimination. Today, the prevention procedure, which, in addition to encompassing the necessary catheterization and handling equipment, is an extended and patient-centered approach. It is extremely important to educate the staff, especially the newly employed staff, and to teach the patient and his family