Effect of precision management scheme based on the best evidence summary on reducing catheter-associated urinary tract infection

• Published in: Zhong nan da xue xue bao. Journal of Central South University. Yi xue ban 2023-09, Vol.48 (9), p.1333-1342
• Main Authors: Ruan, Chunhong, Shi, Shuangjiao, Shen, Zhiying, Guo, Lanping, Gong, Lina
• Format: Article
• Language: chi ; eng
• Subjects: Catheter-Related Infections - epidemiology; Catheter-Related Infections - etiology; Catheter-Related Infections - prevention & control; Catheters, Indwelling - adverse effects; Cross Infection - prevention & control; Humans; Medical Staff; Urinary Catheterization - adverse effects; Urinary Catheterization - methods; Urinary Tract Infections - epidemiology; Urinary Tract Infections - etiology; Urinary Tract Infections - prevention & control
• ISSN: 1672-7347
• DOI: 10.11817/j.issn.1672-7347.2023.230173

Catheter-associated urinary tract infection (CAUTI) is an important cause of prolonged hospital stay, which increases economic and medical burden for patients and hospitals, and it is a key focus of hospital infection prevention and control. However, there are currently few studies that convert evidence-based scientific evidence on CAUTI prevention and control into clinical applications and evaluation on its practical effects in combination with standardized infection ratio (SIR), the critical indicator of infection prevention and control. This study aims to establish a precision management plan for reducing the incidence of CAUTI, driven by the findings of a comprehensive evidence summary, to apply this plan across all the nursing units within the entire hospital, followed by a comparative analysis of CAUTI incidence, SIR, the average duration of indwelling urinary catheter for each patient, and the compliance rate on hand hygiene protocols for medical staff before and after the implementation of the precision management plan. Based on a comprehensive review of the best evidence for preventing CAUTI, a precision management plan was meticulously developed through panel discussions and 2 rounds of expert consultations using Delphi technique. Subsequently, a historical control study was conducted to evaluate the plan's effectiveness. A total of 17 658 patients with indwelling urinary catheter in inpatient departments from January to December 2021 comprised the control group. These patients received standard nursing measures for CAUTI. Another 18 753 patients with indwelling urinary catheters in the inpatient departments from January to December 2022 comprised the intervention group, underwent the precision management scheme based on the best available evidence, to enhance CAUTI prevention. The incidence and SIR of CAUTI, the average duration of indwelling urinary catheter for each patient, and the compliance rate on hand hygiene protocols for medical staff were compared between the 2 groups. Compared with the control group, the incidence of CAUTI in the intervention group was significantly decreased (0.48‰ vs 1.12‰, χ =20.814,