TY - JOUR
T1 - Impact of an evidence-based intervention on urinary catheter utilization, associated process indicators, and infectious and non-infectious outcomes
AU - Schweiger, A.
AU - Kuster, S. P.
AU - Maag, J.
AU - Züllig, S.
AU - Bertschy, S.
AU - Bortolin, E.
AU - John, G.
AU - Sax, H.
AU - Limacher, A.
AU - Atkinson, A.
AU - Schwappach, D.
AU - Marschall, J.
N1 - Funding Information:
The ‘Progress! Safe urinary catheterization’ pilot programme was funded by the Swiss Federal Office of Public Health (SFOPH) and run by the Swiss Patient Safety Foundation , which in turn subcontracted the National Center for Infection Control (Swissnoso) to design and conduct the surveillance component of the study. SFOPH (15.011083) had no role in the study's design, conduct and reporting.
Funding Information:
The ?Progress! Safe urinary catheterization? pilot programme was funded by the Swiss Federal Office of Public Health (SFOPH) and run by the Swiss Patient Safety Foundation, which in turn subcontracted the National Center for Infection Control (Swissnoso) to design and conduct the surveillance component of the study. SFOPH (15.011083) had no role in the study's design, conduct and reporting.
Publisher Copyright:
© 2020 The Author(s)
PY - 2020/10
Y1 - 2020/10
N2 - Background: Multi-centre intervention studies tackling urinary catheterization and its infectious and non-infectious complications are lacking. Aim: To decrease urinary catheterization and, consequently, catheter-associated urinary tract infections (CAUTIs) and non-infectious complications. Methods: Before/after non-randomized multi-centre intervention study in seven hospitals in Switzerland. Intervention bundle consisting of: (1) a concise list of indications for urinary catheterization; (2) daily evaluation of the need for ongoing catheterization; and (3) education on proper insertion and maintenance of urinary catheters. The primary outcome was urinary catheter utilization. Secondary outcomes were CAUTIs, non-infectious complications and process indicators (proportion of indicated catheters and frequency of catheter evaluation). Findings: In total, 25,880 patients were included in this study [13,171 at baseline (August–October 2016) and 12,709 post intervention (August–October 2017)]. Catheter utilization decreased from 23.7% to 21.0% (P=0.001), and catheter-days per 100 patient-days decreased from 17.4 to 13.5 (P=0.167). CAUTIs remained stable at a low level with 0.02 infections per 100 patient-days (baseline) and 0.02 infections (post intervention) (P=0.98). Measuring infections per 1000 catheter-days, the rate was 1.02 (baseline) and 1.33 (post intervention) (P=0.60). Non-infectious complications decreased significantly, from 0.79 to 0.56 events per 100 patient-days (P<0.001), and from 39.4 to 35.4 events per 1000 catheter-days (P=0.23). Indicated catheters increased from 74.5% to 90.0% (P<0.001). Re-evaluations increased from 168 to 624 per 1000 catheter-days (P<0.001). Conclusion: A straightforward bundle of three evidence-based measures reduced catheter utilization and non-infectious complications, whereas the proportion of indicated urinary catheters and daily evaluations increased. The CAUTI rate remained unchanged, albeit at a very low level.
AB - Background: Multi-centre intervention studies tackling urinary catheterization and its infectious and non-infectious complications are lacking. Aim: To decrease urinary catheterization and, consequently, catheter-associated urinary tract infections (CAUTIs) and non-infectious complications. Methods: Before/after non-randomized multi-centre intervention study in seven hospitals in Switzerland. Intervention bundle consisting of: (1) a concise list of indications for urinary catheterization; (2) daily evaluation of the need for ongoing catheterization; and (3) education on proper insertion and maintenance of urinary catheters. The primary outcome was urinary catheter utilization. Secondary outcomes were CAUTIs, non-infectious complications and process indicators (proportion of indicated catheters and frequency of catheter evaluation). Findings: In total, 25,880 patients were included in this study [13,171 at baseline (August–October 2016) and 12,709 post intervention (August–October 2017)]. Catheter utilization decreased from 23.7% to 21.0% (P=0.001), and catheter-days per 100 patient-days decreased from 17.4 to 13.5 (P=0.167). CAUTIs remained stable at a low level with 0.02 infections per 100 patient-days (baseline) and 0.02 infections (post intervention) (P=0.98). Measuring infections per 1000 catheter-days, the rate was 1.02 (baseline) and 1.33 (post intervention) (P=0.60). Non-infectious complications decreased significantly, from 0.79 to 0.56 events per 100 patient-days (P<0.001), and from 39.4 to 35.4 events per 1000 catheter-days (P=0.23). Indicated catheters increased from 74.5% to 90.0% (P<0.001). Re-evaluations increased from 168 to 624 per 1000 catheter-days (P<0.001). Conclusion: A straightforward bundle of three evidence-based measures reduced catheter utilization and non-infectious complications, whereas the proportion of indicated urinary catheters and daily evaluations increased. The CAUTI rate remained unchanged, albeit at a very low level.
KW - CAUTI
KW - Haematuria
KW - Healthcare-associated infection
KW - Infection control
KW - Urinary catheter
UR - http://www.scopus.com/inward/record.url?scp=85090364108&partnerID=8YFLogxK
U2 - 10.1016/j.jhin.2020.07.002
DO - 10.1016/j.jhin.2020.07.002
M3 - Article
C2 - 32653433
AN - SCOPUS:85090364108
SN - 0195-6701
VL - 106
SP - 364
EP - 371
JO - Journal of Hospital Infection
JF - Journal of Hospital Infection
IS - 2
ER -