Reducing the Number One Health Care Acquired Infection Utilizing a Silver-Impregnated Foley with Bacteriostatic Tubing/Bag System

Abstract

BACKGROUND/OBJECTIVES: Catheter-associated urinary tract infections (CAUTI) historically are the number one healthcare-acquired infection (HAI). Zero tolerance of HAI's is a National APIC initiative by 2012. Use of antiseptic urinary catheters has demonstrated reductions in CAUTI's. We compared rates of CAUTI's with the standard Foley/drainage system (baseline) and the silver-coated Foley catheter with antiseptic-impregnated drainage system (intervention). METHODS: A baseline CAUTI rate was established over a 3-month time period using standard latex catheters and drainage systems (A non-Bard product). Retrospective medical review was conducted of all qualifying positive urine cultures during December 1, 2003 through February 28, 2004. Definitions used were those presented at APIC 2004 in the abstract by Ritter, Watson, et al, “Redefining Catheter Associated UTI (CAUTI): Are New Definitions Necessary?” The Bardex®I.C. Complete Care™ System (Bard Medical, Covington, Georgia) with the antiseptic Foley catheter and antiseptic drainage system was the product used for the intervention time period of December 1, 2004 through February 28, 2005. The same qualifying criterion was used for the retrospective review of medical records for the intervention time period. RESULTS: A total of 43 medical records qualified for review (standard Foley catheter). From these, 21 CAUTI's were identified among 14, 375 patient days. During the intervention period, utilizing the antiseptic catheter/drain bag system, 35 medical records qualified for review, from which 11 CAUTI's were identified among 14,035 patient days. The CAUTI rate was reduced from 1.5 cases/1,000 patient days in the standard catheter period to .8 cases per 1,000 patent days in the antiseptic catheter/drainage system period. This represents a 46.6% rate reduction. (RR: 0.536; CI upper limit per 1000 = 1.10, lower limit per 1000 = −1.45; p-value Fisher Exact = 0.089). CONCLUSIONS: The implementation of the Bardex ®I.C. Complete Care™ system was instrumental in reducing of HAI CAUTI's with in our hospital, preventing 10 CAUTI's during the evaluation time period. A projected annualized reduction of 40 CAUTI's would occur and a cost avoidance of ∼ $52,685.04. BACKGROUND/OBJECTIVES: Catheter-associated urinary tract infections (CAUTI) historically are the number one healthcare-acquired infection (HAI). Zero tolerance of HAI's is a National APIC initiative by 2012. Use of antiseptic urinary catheters has demonstrated reductions in CAUTI's. We compared rates of CAUTI's with the standard Foley/drainage system (baseline) and the silver-coated Foley catheter with antiseptic-impregnated drainage system (intervention). METHODS: A baseline CAUTI rate was established over a 3-month time period using standard latex catheters and drainage systems (A non-Bard product). Retrospective medical review was conducted of all qualifying positive urine cultures during December 1, 2003 through February 28, 2004. Definitions used were those presented at APIC 2004 in the abstract by Ritter, Watson, et al, “Redefining Catheter Associated UTI (CAUTI): Are New Definitions Necessary?” The Bardex®I.C. Complete Care™ System (Bard Medical, Covington, Georgia) with the antiseptic Foley catheter and antiseptic drainage system was the product used for the intervention time period of December 1, 2004 through February 28, 2005. The same qualifying criterion was used for the retrospective review of medical records for the intervention time period. RESULTS: A total of 43 medical records qualified for review (standard Foley catheter). From these, 21 CAUTI's were identified among 14, 375 patient days. During the intervention period, utilizing the antiseptic catheter/drain bag system, 35 medical records qualified for review, from which 11 CAUTI's were identified among 14,035 patient days. The CAUTI rate was reduced from 1.5 cases/1,000 patient days in the standard catheter period to .8 cases per 1,000 patent days in the antiseptic catheter/drainage system period. This represents a 46.6% rate reduction. (RR: 0.536; CI upper limit per 1000 = 1.10, lower limit per 1000 = −1.45; p-value Fisher Exact = 0.089). CONCLUSIONS: The implementation of the Bardex ®I.C. Complete Care™ system was instrumental in reducing of HAI CAUTI's with in our hospital, preventing 10 CAUTI's during the evaluation time period. A projected annualized reduction of 40 CAUTI's would occur and a cost avoidance of ∼ $52,685.04.