MP55-17 REDUCING FOLEY CATHETER USAGE IN A PEDIATRIC HOSPITAL USING A BEHAVIORAL NUDGE

Abstract

You have accessJournal of UrologyPediatric Urology V (MP55)1 Sep 2021MP55-17 REDUCING FOLEY CATHETER USAGE IN A PEDIATRIC HOSPITAL USING A BEHAVIORAL NUDGE Daniel Pelzman, Marc Colaco, Omar Ayyash, and Glenn Cannon Daniel PelzmanDaniel Pelzman More articles by this author , Marc ColacoMarc Colaco More articles by this author , Omar AyyashOmar Ayyash More articles by this author , and Glenn CannonGlenn Cannon More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002085.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Catheter-associated urinary tract infections (CAUTI) prolong hospitalizations and increase healthcare costs. The rates of infection are monitored by the Joint Commission and the Centers for Disease Control. As a result, many adult hospitals have instituted policies to reduce their CAUTI rate, but similar efforts have not been well-studied in pediatric hospitals. We sought to investigate whether behavioral modifications including catheter teaching and a daily rounding checklist could reduce unnecessary catheter usage in a 313-bed tertiary-care pediatric hospital. METHODS: Prospectively collected data of urinary catheter utilization at a single pediatric-only hospital from Jan 2015-Dec 2019 were analyzed. In May 2017, hospital-wide mandatory workshops were performed and a nursing-driven daily checklist to assess for catheter necessity was implemented. Pre- and post-intervention catheter utilization rates were compared using the standardized utilization ratio, which is a CDC-developed quality measure of catheter usage defined as total catheter days per total patient days. The intervention was implemented during a seven-month run-in period (May-Dec 2017), which was omitted from analysis. RESULTS: A total of 455,534 patient-days were available for analysis between January 2015 and December 2019. Overall CAUTI rate decreased from 0.13/1000 patient-days to 0.04/1000 patient-days. Hospital-wide catheter utilization decreased from 9.8% (95% confidence interval (CI) [9.4% - 10.3%]) pre-intervention to 3.5% (95% CI [3.3% - 3.8%], p < 0.01) post-intervention (Figure 1). These changes were most pronounced in critical care units where utilization dropped from 35.0% (95% CI [33.5% – 36.4%]) to 12.8% (95% CI [11.6% - 14.1%], p < 0.01). Standardized utilization ratios in the critical care units fell from 2.09 (95% CI [2.00 – 2.19]) to 0.76 (95% CI [0.69 – 0.84], p < 0.01). CONCLUSIONS: Catheter teaching and institution of a daily rounding checklist successfully reduced monthly urethral catheter utilization as measured by catheter usage rates and standardized utilization ratio in a pediatric hospital. Widespread adoption of these protocols may decrease unnecessary catheter usage and catheter-associated morbidity. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e966-e966 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Daniel Pelzman More articles by this author Marc Colaco More articles by this author Omar Ayyash More articles by this author Glenn Cannon More articles by this author Expand All Advertisement Loading ...