Using Existing Databases for Product Evaluation: Silver-Treated Catheter Trial

2.50
Hdl Handle:
http://hdl.handle.net/10755/149323
Type:
Presentation
Title:
Using Existing Databases for Product Evaluation: Silver-Treated Catheter Trial
Abstract:
Using Existing Databases for Product Evaluation: Silver-Treated Catheter Trial
Conference Sponsor:Sigma Theta Tau International
Conference Year:2001
Conference Date:November 10 - 14, 2001
Author:Wagner, Michele
P.I. Institution Name:University of Iowa Hospitals and Clinics
Practice Problem: Urinary Tract Infections (UTIs) account for 40% of hospital acquired infections. It is estimated that between 400,000 and 1,000,000 patients in acute care hospitals develop either nosocomial bacteriuria or UTI each year. The scope of the problem increases when patients in subacute, rehabilitation centers, nursing homes, and those managed in their homes are included. Recent advances in technology have yielded the development of silver-treated indwelling urethral catheters. The intent of coating or impregnating catheters with silver ions is to reduce UTIs. There is a paucity of published research regarding these catheters. Researchers, who conducted in vitro studies, found that silver-treated catheters were effective in reducing bacterial adherence. Prospective randomized clinical trials have also been used to evaluate these catheters. Most researchers have found that silver-treated catheters were effective in reducing UTIs. However, researchers in one study found significantly higher urinary tract infection rates in males, with silver-treated catheters. In spite of limited research and conflicting findings, the C.R. Bard Company provided numerous testimonial documents from hospitals indicating reductions in UTIs associated with utilization of silver-treated catheters. Considering C.R. Bard's confidence in me product they offered me University of Iowa Hospitals and Clinics (UIHC) the "Infection Control Promise Program." According to this program C.R. Bard would provide silver-treated catheters, for a three-month trial, at no additional cost. (Silver-treated catheters cost approximately S3.00/catheter more than the current catheters.) In return, UTHC would compare nosocomial urinary tract infection (NUTI) rates during the three-month trial with previous infection rates. Considering this a performance improvement opportunity, silver-treated catheters were trialed. The aims of this product trial were: (a) to evaluate the manufacturers claims that using silver-treated catheters would result in reductions in NUTIs, and (b) to make recommendations regarding future use of these catheters at UBHC. Despite the benefits of this product evaluation, the trial posed additional practice problems. There are many variables that contribute to the development of UTIs. These risk factors must be carefully evaluated. Therefore, this evaluation posed hidden fiscal burdens for the institution. Nursing time (i.e. manual chart reviews) and frustration (i.e. double documentation on product evaluation forms) associated with retrospective or prospective data collection required for comprehensive evaluations contribute to the institutional costs. This often limits the quality of the product evaluation. Therefore, additional aims of this trial were: (a) to provide a comprehensive evaluation of variables that influence NUTIs and (b) reduce costs and frustrations associated with the product evaluation by using existing databases to gamer comprehensive evaluation data. Lessons Learned: This product trial did not confirm a protective effect of silver-coated catheters on subsequent NUTI incidence. It validates the need to evaluate manufacturers claims when the research-base is limited and there are conflicting reports in the literature. House-wide use of these catheters would have increased annual expenditures by approximately $62,841.74, with no apparent benefit- Patients would have also incurred additional expenses. It also brings to light other possible interventions to decrease NUTI rates. Of the mutable variables in the study, length of stay, catheter duration, use of antibiotics and duration of catheterization were statistically significant predictors of infection and should be further investigated. Further research is recommended since results of this trial are inconsistent with published and unpublished reports of reductions in NUTIs associated with silver-treated catheters. It is noteworthy that previously reported studies have often been tightly controlled efficacy studies while this was an effectiveness trial. Nevertheless, use of unconnectedsystems, subjects with more than one catheter, and catheter system breaks may have altered the results of this trial. Lastly, this product evaluation trial clearly demonstrates that existing databases can be used to facilitate a comprehensive product evaluation, save nursing time, frustration, and money. Therefore, individuals and institutions should be challenged to use existing databases to enhance patient, staff, and fiscal outcomes.
Repository Posting Date:
26-Oct-2011
Date of Publication:
10-Nov-2001
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleUsing Existing Databases for Product Evaluation: Silver-Treated Catheter Trialen_GB
dc.identifier.urihttp://hdl.handle.net/10755/149323-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Using Existing Databases for Product Evaluation: Silver-Treated Catheter Trial</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2001</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">November 10 - 14, 2001</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Wagner, Michele</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Iowa Hospitals and Clinics</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">michelle-wagner@uiowa.edu</td></tr><tr><td colspan="2" class="item-abstract">Practice Problem: Urinary Tract Infections (UTIs) account for 40% of hospital acquired infections. It is estimated that between 400,000 and 1,000,000 patients in acute care hospitals develop either nosocomial bacteriuria or UTI each year. The scope of the problem increases when patients in subacute, rehabilitation centers, nursing homes, and those managed in their homes are included. Recent advances in technology have yielded the development of silver-treated indwelling urethral catheters. The intent of coating or impregnating catheters with silver ions is to reduce UTIs. There is a paucity of published research regarding these catheters. Researchers, who conducted in vitro studies, found that silver-treated catheters were effective in reducing bacterial adherence. Prospective randomized clinical trials have also been used to evaluate these catheters. Most researchers have found that silver-treated catheters were effective in reducing UTIs. However, researchers in one study found significantly higher urinary tract infection rates in males, with silver-treated catheters. In spite of limited research and conflicting findings, the C.R. Bard Company provided numerous testimonial documents from hospitals indicating reductions in UTIs associated with utilization of silver-treated catheters. Considering C.R. Bard's confidence in me product they offered me University of Iowa Hospitals and Clinics (UIHC) the &quot;Infection Control Promise Program.&quot; According to this program C.R. Bard would provide silver-treated catheters, for a three-month trial, at no additional cost. (Silver-treated catheters cost approximately S3.00/catheter more than the current catheters.) In return, UTHC would compare nosocomial urinary tract infection (NUTI) rates during the three-month trial with previous infection rates. Considering this a performance improvement opportunity, silver-treated catheters were trialed. The aims of this product trial were: (a) to evaluate the manufacturers claims that using silver-treated catheters would result in reductions in NUTIs, and (b) to make recommendations regarding future use of these catheters at UBHC. Despite the benefits of this product evaluation, the trial posed additional practice problems. There are many variables that contribute to the development of UTIs. These risk factors must be carefully evaluated. Therefore, this evaluation posed hidden fiscal burdens for the institution. Nursing time (i.e. manual chart reviews) and frustration (i.e. double documentation on product evaluation forms) associated with retrospective or prospective data collection required for comprehensive evaluations contribute to the institutional costs. This often limits the quality of the product evaluation. Therefore, additional aims of this trial were: (a) to provide a comprehensive evaluation of variables that influence NUTIs and (b) reduce costs and frustrations associated with the product evaluation by using existing databases to gamer comprehensive evaluation data. Lessons Learned: This product trial did not confirm a protective effect of silver-coated catheters on subsequent NUTI incidence. It validates the need to evaluate manufacturers claims when the research-base is limited and there are conflicting reports in the literature. House-wide use of these catheters would have increased annual expenditures by approximately $62,841.74, with no apparent benefit- Patients would have also incurred additional expenses. It also brings to light other possible interventions to decrease NUTI rates. Of the mutable variables in the study, length of stay, catheter duration, use of antibiotics and duration of catheterization were statistically significant predictors of infection and should be further investigated. Further research is recommended since results of this trial are inconsistent with published and unpublished reports of reductions in NUTIs associated with silver-treated catheters. It is noteworthy that previously reported studies have often been tightly controlled efficacy studies while this was an effectiveness trial. Nevertheless, use of unconnectedsystems, subjects with more than one catheter, and catheter system breaks may have altered the results of this trial. Lastly, this product evaluation trial clearly demonstrates that existing databases can be used to facilitate a comprehensive product evaluation, save nursing time, frustration, and money. Therefore, individuals and institutions should be challenged to use existing databases to enhance patient, staff, and fiscal outcomes.</td></tr></table>en_GB
dc.date.available2011-10-26T10:00:09Z-
dc.date.issued2001-11-10en_GB
dc.date.accessioned2011-10-26T10:00:09Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.