TY - JOUR
T1 - Change in staff perspectives on indwelling urinary catheter use after implementation of an intervention bundle in seven Swiss acute care hospitals
T2 - Results of a before/after survey study
AU - Niederhauser, Andrea
AU - Züllig, Stephanie
AU - Marschall, Jonas
AU - Schweiger, Alexander
AU - John, Gregor
AU - Kuster, Stefan P.
AU - Schwappach, David L.B.
N1 - Funding Information:
Funding This work was supported by a grant from the Swiss Federal Office of Public Health (no 15.011083).
Publisher Copyright:
© 2019 Author(s).
PY - 2019/10/1
Y1 - 2019/10/1
N2 - Objective To evaluate changes in staff perspectives towards indwelling urinary catheter (IUC) use after implementation of a 1-year quality improvement project. Design Repeated cross-sectional survey at baseline (October 2016) and 12-month follow-up (October 2017). Setting Seven acute care hospitals in Switzerland. Participants The survey was targeted at all nursing and medical staff members working at the participating hospitals at the time of survey distribution. A total of 1579 staff members participated in the baseline survey (T 0) (49% response rate) and 1527 participated in the follow-up survey (T 1) (47% response rate). Intervention A multimodal intervention bundle, consisting of an evidence-based indication list, daily re-evaluation of ongoing catheter need and staff training, was implemented over the course of 9 months. Main outcome measures Staff knowledge (15 items), perception of current practices and culture (scale 1-7), self-reported responsibilities (multiple-response question) and determinants of behaviour (scale 1-7) before and after implementation of the intervention bundle. Results The mean number of correctly answered knowledge questions increased significantly between the two survey periods (T 0: 10.4, T 1: 11.0; p<0.001). Self-reported responsibilities with regard to IUC management by nurses and physicians changed only slightly over time. Perception of current practices and culture in regard to safe urinary catheter use increased significantly (T 0: 5.3, T 1: 5.5; p<0.001). Significant changes were also observed for determinants of behaviour (T 0: 5.3, T 1: 5.6; p<0.001). Conclusion We found small but significant changes in staff perceptions after implementation of an evidence-based intervention bundle. Efforts now need to be targeted at sustaining and reinforcing these changes, so that restrictive use of IUCs becomes an integral part of the hospital culture.
AB - Objective To evaluate changes in staff perspectives towards indwelling urinary catheter (IUC) use after implementation of a 1-year quality improvement project. Design Repeated cross-sectional survey at baseline (October 2016) and 12-month follow-up (October 2017). Setting Seven acute care hospitals in Switzerland. Participants The survey was targeted at all nursing and medical staff members working at the participating hospitals at the time of survey distribution. A total of 1579 staff members participated in the baseline survey (T 0) (49% response rate) and 1527 participated in the follow-up survey (T 1) (47% response rate). Intervention A multimodal intervention bundle, consisting of an evidence-based indication list, daily re-evaluation of ongoing catheter need and staff training, was implemented over the course of 9 months. Main outcome measures Staff knowledge (15 items), perception of current practices and culture (scale 1-7), self-reported responsibilities (multiple-response question) and determinants of behaviour (scale 1-7) before and after implementation of the intervention bundle. Results The mean number of correctly answered knowledge questions increased significantly between the two survey periods (T 0: 10.4, T 1: 11.0; p<0.001). Self-reported responsibilities with regard to IUC management by nurses and physicians changed only slightly over time. Perception of current practices and culture in regard to safe urinary catheter use increased significantly (T 0: 5.3, T 1: 5.5; p<0.001). Significant changes were also observed for determinants of behaviour (T 0: 5.3, T 1: 5.6; p<0.001). Conclusion We found small but significant changes in staff perceptions after implementation of an evidence-based intervention bundle. Efforts now need to be targeted at sustaining and reinforcing these changes, so that restrictive use of IUCs becomes an integral part of the hospital culture.
KW - indwelling urinary catheter
KW - intervention bundle
KW - patient safety
KW - perception
KW - survey
UR - http://www.scopus.com/inward/record.url?scp=85074284450&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2018-028740
DO - 10.1136/bmjopen-2018-028740
M3 - Article
C2 - 31662357
AN - SCOPUS:85074284450
VL - 9
JO - BMJ Open
JF - BMJ Open
SN - 2044-6055
IS - 10
M1 - e028740
ER -