Effectiveness of a simple intervention for prevention of catheter-associated urinary tract infections on a medical hospital unit.

Abstract

Urinary tract infections (UTI) are one of the most common hospital-acquired infections with 80% as a result of urinary catheterisation. This study examined the impact of a simple intervention consisting of a daily chart reminder in patients with indwelling urinary catheters (IUC) on the duration of catheter use and the incidence of catheter-associated UTIs (CAUTIs). The trial used a prospective pretest-post-test design with a control group over a six-month period conducted on two medical units of a community teaching hospital. We included all patients admitted to two medical units between 1 June and 30 November 2016 who had an IUC inserted at the study site. During the intervention phase, a sticker was placed in the charts of patients with urinary catheters reminding physicians to assess for catheter removal if not clinically necessary. A total of 195 patients participated in this study (112 control unit, 83 intervention unit). There was a decrease in the duration of IUC use on the intervention unit from 11.7 days to 7.5 days (P = 0.0028). There was a decrease in repeated catheterisation from 11.1% to 2.1% (P = 0.0882), and CAUTIs from 17.5% to 4.6% (P = 0.0552) but this did not reach statistical significance. The implementation of a daily IUC reminder sticker in patient charts was associated with a significant reduction in the mean duration of indwelling catheter use with a trend towards a reduction in the frequency of repeated urinary catheterisation and rate of CAUTIs.