Silver Coated Foley Catheters – Initial Cost Is Not the Only Thing To Consider

Abstract

BACKGROUND/OBJECTIVES: Nearly 40% of healthcare associated infections (HAI) are urinary tract infections. Catheter associated urinary tract infections (CAUTI) account for 90% of these infections. The hospitals' mission statement encouraged us to seek alternatives to improve quality. The hospital was willing to increase cost for a product initially to improve patient outcome, improve quality and save money. Also, due to an increase in the number of patients with latex allergies, the hospital wanted a latex free catheter. METHODS: Matched surveillance was conducted for baseline and product evaluation periods. CDC definitions were used for case definition. Numerator was CAUTI, denominator was device days in ICU, patient days in all other inpatient units. Patient population included all inpatients over the age of 18 with foley catheters who developed HAI - CAUTI. In 2004 the hospital wanted to improve CAUTI rates and switch to a latex free catheter. All current latex catheters were removed in June, product was converted to Dover silver, staff inserviced. Same methodology for data collection and data analysis was used for both time periods. Annual cost data was used as comparison for both products. RESULTS: The annual cost comparison of the two catheters was $37,023 for the non coated latex catheter, $65,725 for the silver coated catheter. The cost difference was $28,702. There were 34 CAUTI with the latex catheter compared to 12 with the silver coated catheter. If the average cost of a CAUTI was $1000 ,there would have to be 29 less CAUTI to see a flat savings on catheters alone. There were 22 less infections in the silver group, a cost saving of $22,000. There were 0 infections in the ICU group compared to 7 CAUTI before the catheter was switched, a $7000 savings. CONCLUSIONS: The use of the silver coated catheter resulted in more than a 50 % decrease in CAUTI. Other cost factors such as antibiotic usage to treat CAUTI, the number of patients who would have developed antibiotic resistant organisms requiring contact isolation and the cost associated with isolation, were not taken into account which would have made the cost savings higher. Cost factors are not always black and white. You need to look at all the benefits to the patient not just the bottom line. These factors are more difficult to measure. Inpatient Units HAI - CAUTI rate July 2003-June 2005 CAUTI rate Non silver catheter - July 2003- June 2004 Silver coated catheter - July 2004- June 2005 # of CAUTI 34 12 patient days 65613 65307 incidence ratios 0.51 0.18 HAI-CAUTI in ICU inpatients July 2003- June 2005 CAUTI Rate Non silver catheter - July 2003- June 2004 Silver coated catheter - July 2004- June 2005 # of infections 7 0 Device days 4593 5082 Incidence ratio 1.5 0