Foley catheter practices and knowledge among Minnesota physicians

• Published in: American journal of infection control 2010-11, Vol.38 (9), p.694-700
• Main Authors: Drekonja, Dimitri M., MD, MS, Kuskowski, Michael A., PhD, Johnson, James R., MD
• Format: Article
• Language: English
• Subjects: Attitude of Health Personnel; Bacterial diseases; Bacterial diseases of the urinary system; Biological and medical sciences; Catheter-Related Infections - epidemiology; Catheter-Related Infections - prevention & control; Catheters; Clinical medicine; Data Collection - methods; Epidemiology. Vaccinations; General aspects; Health Knowledge, Attitudes, Practice; Human bacterial diseases; Humans; Infection Control; Infectious Disease; Infectious diseases; Internet; Intubation; Medical sciences; Minnesota; Nephrology. Urinary tract diseases; Physicians; prevention; Surveys and Questionnaires; Urinary catheter; Urinary Catheterization - adverse effects; Urinary Catheterization - methods; Urinary Catheterization - utilization; Urinary system involvement in other diseases. Miscellaneous; Urinary tract diseases; urinary tract infection; Urinary Tract Infections - epidemiology; Urinary Tract Infections - prevention & control; Urinary tract. Prostate gland
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2010.03.011

Background Urinary catheter use is common, and physicians are often unaware of the presence of a catheter in a patient. Despite this, and despite a recent policy change classifying catheter-associated urinary tract infection (CAUTI) as nonreimbursable, little is known regarding physicians' knowledge and attitudes regarding catheters, or their responses to the policy change. Methods Licensed Minnesota physicians were sent an Internet-based survey regarding indications for Foley catheter placement, effectiveness of interventions for preventing CAUTI, and knowledge of and response to the changed reimbursement policy. Results Overall, respondents exhibited good knowledge regarding indications for catheterization, with the 2 indications most widely accepted as being valid (critical illness with tenuous volume status and urinary obstruction) receiving the highest appropriateness scores. Most respondents reported awareness of the changed reimbursement policy for CAUTI; fully one-third indicated that because of this change, they now removed catheters earlier than previously. The responses from primary care physicians and surgeons differed significantly in terms of indications for catheterization, methods to prevent CAUTI, and the impact of the policy change on their practice patterns. Conclusion Respondents demonstrated relatively good knowledge regarding Foley catheter use, and most were aware of the changed CAUTI reimbursement policy. Surgeons and primary care physicians may have different approaches to catheter management. Efforts are needed to translate catheter-related knowledge into good clinical practice.