Reducing Indwelling Urinary Catheter Device Days and Catheter-Associated Urinary Tract Infections in a MICU

2.50
Hdl Handle:
http://hdl.handle.net/10755/157123
Category:
Abstract
Type:
Presentation
Title:
Reducing Indwelling Urinary Catheter Device Days and Catheter-Associated Urinary Tract Infections in a MICU
Author(s):
Killeen, Kathryn; Elpern, Ellen; Lateef, Omar
Author Details:
Kathryn Killeen, Rush University Medical Center, Chicago, Illinois, USA, email: Kathryn_M_Killeen@rush.edu; Ellen Elpern; Omar Lateef
Abstract:
PURPOSE: To implement and evaluate a multidisciplinary initiative to reduce catheter associated urinary tract infections (CAUTIs) in a Medical Intensive Care Unit (MICU) by decreasing urinary catheter device use. BACKGROUND: Indwelling urinary catheters are used commonly in ICUs. CAUTIs increase with duration of catheter use, with risk estimated to be at least 5% per day. Strategies to prevent CAUTIs have focused on catheter materials, drainage systems, insertion techniques, and use of anti-infectives. Among all methods investigated, the most important intervention to prevent CAUTIs is limiting catheter use. Urinary infections in the critically ill can increase length of ICU stay and mortality. METHODS: Indications for the maintenance of indwelling urinary catheters were developed by a team of critical care clinicians. For a six month intervention period, patients in an MICU with indwelling urinary catheters were evaluated daily using criteria for appropriate catheter continuance. Recommendations were made to discontinue indwelling urinary catheters in patients who did not meet appropriateness criteria. Urinary catheter device days and rates of CAUTIs during the intervention were compared with those of the previous 11 months. Unpaired t tests were used to determine statistical significance with a p value < 0.05 considered significant. RESULTS: 337 patients with indwelling urinary catheters were encountered during the 6 month intervention, with 1432 urinary catheter device days. Overall, 456 of the 1432 device days (32%) were considered inappropriate. Reasons for catheter continuation against recommendation were incontinence, particularly in female patients, and concern for skin integrity. With use of guidelines, urinary catheter device days were reduced to an average of 238.6 days per month from the pre-intervention rate of 311.7 catheter days per month (p=0.01). There were no CAUTIs in the six month intervention period compared to an average pre-intervention monthly rate of 4.4 CAUTIs per 1000 device days (p=0.0005). CONCLUSIONS: CAUTIs are among complications fundamentally linked to nursing care and will likely constitute a measure of nursing care performance. Our results confirm that urinary catheter device days and CAUTIs can be reduced by daily determinations by nurses of the need for the catheter.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.
Conference Date:
2009
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
New Orleans, Louisiana, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleReducing Indwelling Urinary Catheter Device Days and Catheter-Associated Urinary Tract Infections in a MICUen_GB
dc.contributor.authorKilleen, Kathrynen_GB
dc.contributor.authorElpern, Ellenen_GB
dc.contributor.authorLateef, Omaren_GB
dc.author.detailsKathryn Killeen, Rush University Medical Center, Chicago, Illinois, USA, email: Kathryn_M_Killeen@rush.edu; Ellen Elpern; Omar Lateefen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157123-
dc.description.abstractPURPOSE: To implement and evaluate a multidisciplinary initiative to reduce catheter associated urinary tract infections (CAUTIs) in a Medical Intensive Care Unit (MICU) by decreasing urinary catheter device use. BACKGROUND: Indwelling urinary catheters are used commonly in ICUs. CAUTIs increase with duration of catheter use, with risk estimated to be at least 5% per day. Strategies to prevent CAUTIs have focused on catheter materials, drainage systems, insertion techniques, and use of anti-infectives. Among all methods investigated, the most important intervention to prevent CAUTIs is limiting catheter use. Urinary infections in the critically ill can increase length of ICU stay and mortality. METHODS: Indications for the maintenance of indwelling urinary catheters were developed by a team of critical care clinicians. For a six month intervention period, patients in an MICU with indwelling urinary catheters were evaluated daily using criteria for appropriate catheter continuance. Recommendations were made to discontinue indwelling urinary catheters in patients who did not meet appropriateness criteria. Urinary catheter device days and rates of CAUTIs during the intervention were compared with those of the previous 11 months. Unpaired t tests were used to determine statistical significance with a p value < 0.05 considered significant. RESULTS: 337 patients with indwelling urinary catheters were encountered during the 6 month intervention, with 1432 urinary catheter device days. Overall, 456 of the 1432 device days (32%) were considered inappropriate. Reasons for catheter continuation against recommendation were incontinence, particularly in female patients, and concern for skin integrity. With use of guidelines, urinary catheter device days were reduced to an average of 238.6 days per month from the pre-intervention rate of 311.7 catheter days per month (p=0.01). There were no CAUTIs in the six month intervention period compared to an average pre-intervention monthly rate of 4.4 CAUTIs per 1000 device days (p=0.0005). CONCLUSIONS: CAUTIs are among complications fundamentally linked to nursing care and will likely constitute a measure of nursing care performance. Our results confirm that urinary catheter device days and CAUTIs can be reduced by daily determinations by nurses of the need for the catheter.en_GB
dc.date.available2011-10-26T19:26:30Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:26:30Z-
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.conference.date2009en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationNew Orleans, Louisiana, USAen_GB
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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