Eliminating Catheter-Associated Urinary Tract Infections

Winter, Melissa; Helms, B.; Harrington, Linda; Luquire, Rosemary; McVay, Tonya; Rhodes, Nancy

doi:10.1111/j.1945-1474.2009.00049.x

Cited by 12 publications

(13 citation statements)

References 9 publications

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“…Use of straight catheters for urine collection and female urinals for urine output can accomplish these tasks without the need for an indwelling catheter. 16,17 These practice patterns deserve further investigation and provide reasonable targets for education and hospital interventions.…”

Section: Discussionmentioning

confidence: 99%

Urinary Catheter Use and Appropriateness in U.S. Emergency Departments, 1995–2010

Schuur

Chambers

Hou

2014

Academic Emergency Medicine

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Objectives: Catheter-associated urinary tract infection (CAUTI) is the most prevalent hospital-acquired infection, yet little is known about emergency department (ED) use of urinary catheters. The objective was to describe use of urinary catheters in U.S. EDs and determine the proportion that was potentially avoidable.Methods: The National Hospital Ambulatory Medical Care Survey (NHAMCS), a weighted probability sample of U.S. ED visits, was analyzed from 1995 through 2010 for use of urinary catheters in adults. Use of a urinary catheter was a specific chart review element and was classified as potentially avoidable if none of the Centers for Disease Control and Prevention (CDC) list of appropriate indications were met by ED visit diagnoses or patient disposition. Annual frequency of urinary catheter use and appropriateness were calculated. Predictors of ED-placed urinary catheters for admitted patients were assessed with multivariate logistic regression. Results:The annual rate of ED-placed urinary catheters varied from 2.2 to 3.3 per 100 adult ED visits. Among admitted patients, 8.5% (95% confidence interval [CI] = 8.0% to 9.1%) received urinary catheters; 64.9% (95% CI = 56.9% to 72.9%) were potentially avoidable. Among discharged patients 1.6% (95% CI = 1.5% to 1.7%) received urinary catheters. There was no significant trend over time in the use of urinary catheters or potentially avoidable urinary catheters (PAUCs). Predictors of catheter use in admitted patients included indicators of patient severity, female sex, and race/ethnicity. Hospital characteristics predicting catheter use included region, ownership type, and urban location. Predictors of potentially avoidable urinary catheter use were lower patient severity, female sex, care by a midlevel practitioner, and nonurban location.Conclusions: Reducing use of urinary catheters outside of CDC guideline criteria in ED patients is a promising strategy to reduce CAUTIs.ACADEMIC EMERGENCY MEDICINE 2014; 21:292-300

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Section: Discussionmentioning

confidence: 99%

Urinary Catheter Use and Appropriateness in U.S. Emergency Departments, 1995–2010

Schuur

Chambers

Hou

2014

Academic Emergency Medicine

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“…Thus, there are good reasons for trying to lower the incidence of CAUTIs [6]. One obvious way of achieving this is to avoid unnecessary use of indwelling urinary catheters [7]. Since the risk of bacteriuria increases linearly with each additional catheter day, it is important to keep the duration of catheter use as short as possible [8].…”

Section: Introductionmentioning

confidence: 99%

Noble metal alloy-coated latex versus silicone Foley catheter in short-term catheterization: A randomized controlled study

Stenzelius

Persson

Olsson

et al. 2011

Scandinavian Journal of Urology and Nephrology

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“…Urinary tract infections (UTIs) are one of the leading hospital acquired infections, [3][4][5] they can be life-threatening and may lead to increased morbidity, length of hospitalization, and highly affects the costs of healthcare. [1][2][3] It is believed that urinary instrumentation, primarily urinary catheterization, is responsible for nearly 80% of the infections, defined as catheter-associated urinary tract infection (CAUTI).…”

Section: Introductionmentioning

confidence: 99%

Compliance With Guideline Statements for Urethral Catheterization in an Iranian Teaching Hospital

Taleschian-Tabrizi

Farhadi

Madani

et al. 2015

Int J Health Policy Manag

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Background: It is believed that healthcare staff play an important role in minimizing complications related to urethral catheterization. The purpose of this study was to determine whether or not healthcare staff complied with the standards for urethral catheterization. Methods: This study was conducted in Imam Reza teaching hospital, Tabriz, Iran, from July to September 2013. A total of 109 catheterized patients were selected randomly from surgical and medical wards and intensive care units (ICUs). A questionnaire was completed by healthcare staff for each patient to assess quality of care provided for catheter insertion, while catheter in situ, draining and changing catheter bags. Items of the questionnaire were obtained from guidelines for the prevention of infection. Data analysis was performed with SPSS 16. Results: The mean age of the patients was 50.54 ± 22.13. Of the 109 patients, 56.88% were admitted to ICUs. The mean duration of catheter use was 15.86 days. Among the 25 patients who had a urinalysis test documented in their hospital records, 11 were positive for urinary tract infection (UTI). The lowest rate of hand-washing was reported before bag drainage (49.52%). The closed drainage catheter system was not available at all. Among the cases who had a daily genital area cleansing, in 27.63% cases, the patients or their family members performed the washing. In 66.35% of cases, multiple-use lubricant gel was applied; single-use gel was not available. The rate of documentation for bag change was 79%. Conclusion: The majority of the guideline statements was adhered to; however, some essential issues, such as hand hygiene were neglected. And some patients were catheterized routinely without proper indication. Limiting catheter use to mandatory situations and encouraging compliance with guidelines are recommended. Implications for policy makers• The first step in improvement is to identify and address the deficits. There is a gap between evidence-based recommendations and the practice for urethral catheterization. • Routine and prolonged catheterization, without appropriate necessity is reported, which can lead to a high rate of catheter-associated urinary tract infection (CAUTI) and accompanying healthcare costs. • Adapting evidence-based guidelines and increasing patients' knowledge can be a solution for this apparently simple but indeed important problem. Implications for publicAppraising the quality of healthcare provided and identifying the gaps in the system are the main bases of further directions for health policies. Iatrogenic infections such as catheter-associated urinary tract infection (CAUTI) are among the most widespread complications and can lead to increased morbidity and length of hospitalization and to affect the costs of healthcare significantly. These problems can be prevented easily by appropriate practices. [1][2][3] This article revealed the gap between evidence-based recommendations and the practice for urethral catheterization. Filling these gaps by developing evidence-base...

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Eliminating Catheter-Associated Urinary Tract Infections

Cited by 12 publications

References 9 publications

Urinary Catheter Use and Appropriateness in U.S. Emergency Departments, 1995–2010

Urinary Catheter Use and Appropriateness in U.S. Emergency Departments, 1995–2010

Noble metal alloy-coated latex versus silicone Foley catheter in short-term catheterization: A randomized controlled study

Compliance With Guideline Statements for Urethral Catheterization in an Iranian Teaching Hospital

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