Increasing patient safety through the use of silver-coated 100% silicone Foley catheter system

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BACKGROUND/OBJECTIVES: Catheter-associated urinary tract infections (CAUTIs) pose a significant threat to our aging population and our hospitalized patients and contribute to the development of antibiotic-resistant organisms. This is a 214-bed medical center, including a 60-bed skilled nursing facility (SNF). The hospital serves nearly 120,000 residents of the east end of Long Island. To determine the impact on patient safety and CAUTI reduction, a decision was made to evaluate a silver-coated 100% silicone Foley catheter system in comparison to the current non-silver-coated latex Foley catheter system. METHODS: Total facility surveillance, including the SNF, of healthcare-associated CAUTIs was completed using the current Centers for Disease Control and Prevention (CDC) definitions. A comprehensive chart review was conducted for all adult inpatients with Foley catheters who presented with positive urine cultures at least 48 hours after admission. Patients with chronic Foley catheters and catheters inserted in the surgical department were excluded. The baseline period utilizing latex Foley catheters was July 1–September 30, 2003. These results were then compared to July 1–October 15, 2004, utilizing the silver-coated 100% silicone Foley catheter. RESULTS: Results revealed an overall CAUTI reduction of 75% with the implementation of a silver-coated 100% silicone Foley catheter system. Using the latex Foley catheter system, the average CAUTI rate was 2.16 infections per 1000 hospital patient days and 0.19 infections per 1000 SNF patient days. A total of 19 organisms, three resistant, were identified in urine cultures. Using the silver-coated 100% silicone Foley catheter system, the average CAUTI rate was 0.53 infections per 1000 hospital patient days and 0 infections per 1000 SNF patient days. A total of 7 organisms, none resistant, were identified in urine cultures. Using an average cost for CAUT of $2204, a net annual cost avoidance of $80,160 was computed. CONCLUSIONS: These findings suggest that silver-coated 100% silicone Foley catheters are effective at reducing the incidence of CAUTI and resistant organisms in an acute care hospital and a SNF, thereby increasing patient safety. In addition to offering a significant patient safety intervention, these catheters also offer a significant cost savings to the facility.