Reduction in catheter-associated urinary tract infection (CAUTI) using a silver-coated all-silicone Foley catheter versus a silver-impregnated latex Foley catheter in a Southeastern U.S. long-term acute care facility

Abstract

BACKGROUND: Infection control surveillance for nosocomial catheter-associated urinary tract infection (CAUTI) is often performed in intensive care units (ICUs) where comparison to NNIS data is possible. There is much information regarding CAUTI incidence in large teaching facilities. However, there are few benchmarks for use in small specialty facilities. This facility is a 49 bed long-term acute care (LTAC) hospital located in the Southeastern United States. Average LOS (length of stay) is >25 days. The LTAC serves a geographic radius of approximately 100 miles. OBJECTIVES: Compare the facility's existing CAUTI rate using a silver-impregnated latex Foley catheter to the CAUTI rate using a silver-coated all-silicone catheter. Quantify the economic and patient safety impact on this hospital. METHODS: Total facility surveillance of nosocomial CAUTIs was completed using Centers for Disease Control and Prevention (CDC) definitions. A comprehensive concurrent chart review was conducted for all patients with Foley catheters who presented with positive urine cultures >48 hours after admission. The baseline period utilizing the silver latex catheter was March–December 2003. These months were then compared to the same months utilizing the all-silicone silver-coated Foley in the subsequent year. RESULTS: The novel silver-coated all-silicone Foley catheter had 17% fewer CAUTIs in the time period studied. Compliance with hand hygiene and Foley catheter care was similar during the two timeframes. The calculated cost savings in the trial period was $49,439. CONCLUSIONS: Use of a novel silver-coated all-silicone Foley catheter resulted in major reductions in the incidence of CAUTI and cost. Switching to all-silicone silver-coated urinary catheters in the LTAC setting could substantially decrease nosocomial CAUTI, thereby improving patient safety. Further investigation is recommended. BACKGROUND: Infection control surveillance for nosocomial catheter-associated urinary tract infection (CAUTI) is often performed in intensive care units (ICUs) where comparison to NNIS data is possible. There is much information regarding CAUTI incidence in large teaching facilities. However, there are few benchmarks for use in small specialty facilities. This facility is a 49 bed long-term acute care (LTAC) hospital located in the Southeastern United States. Average LOS (length of stay) is >25 days. The LTAC serves a geographic radius of approximately 100 miles. OBJECTIVES: Compare the facility's existing CAUTI rate using a silver-impregnated latex Foley catheter to the CAUTI rate using a silver-coated all-silicone catheter. Quantify the economic and patient safety impact on this hospital. METHODS: Total facility surveillance of nosocomial CAUTIs was completed using Centers for Disease Control and Prevention (CDC) definitions. A comprehensive concurrent chart review was conducted for all patients with Foley catheters who presented with positive urine cultures >48 hours after admission. The baseline period utilizing the silver latex catheter was March–December 2003. These months were then compared to the same months utilizing the all-silicone silver-coated Foley in the subsequent year. RESULTS: The novel silver-coated all-silicone Foley catheter had 17% fewer CAUTIs in the time period studied. Compliance with hand hygiene and Foley catheter care was similar during the two timeframes. The calculated cost savings in the trial period was $49,439. CONCLUSIONS: Use of a novel silver-coated all-silicone Foley catheter resulted in major reductions in the incidence of CAUTI and cost. Switching to all-silicone silver-coated urinary catheters in the LTAC setting could substantially decrease nosocomial CAUTI, thereby improving patient safety. Further investigation is recommended.