Evaluation of the Impact on Patient Safety Resulting from Use of Silver-Coated Foley Catheters in a Community Hospital

Abstract

BACKGROUND: Research into prevention of catheter-associated urinary tract infections (CA-UTIs) with the use of silver-coated Foley catheters (SCFCs) has been documented in several large university medical centers. Little is known about the impact of SCFCs in smaller community hospitals. Olean General Hospital (OGH) is a 103-year-old, 186-bed community medical center located in Olean, New York. The Hospital has a primary service area of 60,000 people. OBJECTIVES: Determine the impact on patient safety resulting from use of SCFCs to reduce the incidence of CA-UTI in a community medical center. Quantify the economic impact of this intervention for the hospital. METHODS: House-wide surveillance of nosocomial CA-UTIs was completed using CDC definitions. A comprehensive chart review was conducted for all patients with Foley catheters who presented with positive urine cultures at >48 hours after admission. The baseline period employing regular Foley catheters (RFCs) was February, March, and April 2001. These results were then compared to the same months using SCFCs in 2002. RESULTS: The following incidence of CA-UTI was observed in the baseline period: February, 6 per 2402 patient days; March, 9 per 2853 patient days; April, 13 per 2607 patient days. This represents an average rate of CA-UTI of 3.6 infections per 1000 patient days. The following incidence of CA-UTI was observed in the evaluation period: February, 2 per 2852 patient days, March, 3 per 2485 patient days, April, 5 per 2828 patient days. This represents an average rate of CA-UTI of 1.2 infections per 1000 patient days. The relative risk of CA-UTI per 1000 patient days with the SCFC compared to the RFC was 0.35 (95% confidence interval, 0.17–0.71; p=0.003). Using an average cost for CA-UTI of $3803, a net annual cost avoidance of $221,359 was computed. CONCLUSION: SCFCs can reduce the incidence of CA-UTI in a community medical center by 65%. These catheters also offer a significant cost savings to the facility. Based on these patient safety and economic benefits, SCFCs are the standard of care at OGH.