Impact of an evidence-based intervention on urinary catheter utilization, associated process indicators, and infectious and non-infectious outcomes

Multi-centre intervention studies tackling urinary catheterization and its infectious and non-infectious complications are lacking. To decrease urinary catheterization and, consequently, catheter-associated urinary tract infections (CAUTIs) and non-infectious complications. Before/after non-randomiz...

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Bibliographic Details
Published in:The Journal of hospital infection 2020-10, Vol.106 (2), p.364-371
Main Authors: Schweiger, A., Kuster, S.P., Maag, J., Züllig, S., Bertschy, S., Bortolin, E., John, G., Sax, H., Limacher, A., Atkinson, A., Schwappach, D., Marschall, J.
Format: Article
Language:English
Subjects:
CAUTI
Haematuria
Healthcare-associated infection
Infection control
Urinary catheter
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Summary:Multi-centre intervention studies tackling urinary catheterization and its infectious and non-infectious complications are lacking. To decrease urinary catheterization and, consequently, catheter-associated urinary tract infections (CAUTIs) and non-infectious complications. 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). 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
ISSN:0195-6701
1532-2939
DOI:10.1016/j.jhin.2020.07.002