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Catheter-Associated Urinary Tract Infections in Intensive Care Units Can Be Reduced by Prompting Physicians to Remove Unnecessary Catheters

Published online by Cambridge University Press:  02 January 2015

Wei-Chun Huang ,
Shue-Ren Wann ,
Shoa-Lin Lin ,
Calvin M. Kunin ,
Ming-Ho Kung ,
Chin-Hsun Lin ,
Chien-Wei Hsu ,
Chun-Peng Liu ,
Susan Shin-Jung Lee  and
Yung-Ching Liu
...Show all authors
Wei-Chun Huang
Affiliation:
Intensive Care Unit, Veterans General Hospital, Kaohsiung, China
Shue-Ren Wann
Affiliation:
Intensive Care Unit, Veterans General Hospital, Kaohsiung, China Section of Infectious Diseases and Microbiology, Kaohsiung, Veterans General Hospital, Kaohsiung, China
Shoa-Lin Lin*
Affiliation:
Intensive Care Unit, Veterans General Hospital, Kaohsiung, China National Yang-Ming University, School of Medicine, Taipei, Taiwan, Republic of China
Calvin M. Kunin
Affiliation:
Ohio State University College of Medicine and Public Health, Columbus, Ohio
Ming-Ho Kung
Affiliation:
Intensive Care Unit, Veterans General Hospital, Kaohsiung, China
Chin-Hsun Lin
Affiliation:
Intensive Care Unit, Veterans General Hospital, Kaohsiung, China
Chien-Wei Hsu
Affiliation:
Intensive Care Unit, Veterans General Hospital, Kaohsiung, China
Chun-Peng Liu
Affiliation:
National Yang-Ming University, School of Medicine, Taipei, Taiwan, Republic of China
Susan Shin-Jung Lee
Affiliation:
Section of Infectious Diseases and Microbiology, Kaohsiung, Veterans General Hospital, Kaohsiung, China
Yung-Ching Liu
Affiliation:
Section of Infectious Diseases and Microbiology, Kaohsiung, Veterans General Hospital, Kaohsiung, China
Kwok-Hung Lai
Affiliation:
National Yang-Ming University, School of Medicine, Taipei, Taiwan, Republic of China
Tzu-Wen Lin
Affiliation:
Chengshiu Institute of Technology, Kaohsiung, Taiwan, Republic of China
*
Intensive Care Unit, Kaohsiung Veterans General Hospital, No. 386, Dar-Chung First Road, Kaohsiung, Taiwan, Republic of China
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Abstract

Objective:

Indwelling urinary catheters are the most common source of infections in intensive care units (ICUs). The aim of this study was to evaluate the efficacy of nurse-generated daily reminders to physicians to remove unnecessary urinary catheters 5 days after insertion.

Design:

A time-sequence nonrandomized intervention study.

Setting:

Adult ICUs (medical, surgical, cardiovascular surgical, neurosurgical, and coronary care) of a tertiary-care university medical center.

Patients:

All patients admitted to the adult ICUs during a 2-year period. The study consisted of a 12-month observational phase (15,960 patient-days) followed by a 12-month intervention phase (15,525 patient-days).

Intervention:

Daily reminders to physicians from the nursing staff to remove unnecessary urinary catheters 5 days after insertion.

Results:

The duration of urinary catheterization was significantly reduced during the intervention phase (from 7.0 ± 1.1 days to 4.6 ± 0.7 days; P < .001). The rate of catheter-associated urinary tract infection (CAUTI) was also significantly reduced (from 11.5 ± 3.1 to 8.3 ± 2.5 patients with CAUTI per 1,000 catheter-days; P = .009). There was a linear relationship between the monthly average duration of catheterization and the rate of CAUTI (r = 0.50; P = .01). The excess monthly cost of antibiotics for CAUTI was reduced by 69% (from $4,021 ± $1,800 to $1,220 ± $941; P = .004).

Conclusion:

This study demonstrated that a simple measure instituted as part of a continuous quality improvement program significantly reduced the duration of urinary catheterization, rate of CAUTI, and additional costs of antibiotics to manage CAUTI.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 11 , November 2004 , pp. 974 - 978
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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