In:
Infection Control & Hospital Epidemiology, Cambridge University Press (CUP), Vol. 25, No. 11 ( 2004-11), p. 974-978
Abstract:
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 of Medium:
Online Resource
ISSN:
0899-823X
,
1559-6834
Language:
English
Publisher:
Cambridge University Press (CUP)
Publication Date:
2004
detail.hit.zdb_id:
2106319-9
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