Catheter-associated Urinary Tract Infection Prevention Research Articles

Nanozyme-reinforced hydrogel coatings for prevention of catheter-associated urinary tract infection

Catheter-associated urinary tract infection (CAUTI) presents a significant clinical challenge globally, given its elevated infection risk, substantial treatment costs, and the emergence of drug-resistant strains. Despite extensive clinical endeavors, such as the development of antimicrobial catheters and prophylactic approaches, addressing CAUTI remains intricate due to the microenvironment complexity, sustained antimicrobial requirements, the necessity for antibiofilm strategies, and concurrent inflammatory responses. Herein, an innovative solution involving an ultra-low loading gold/iron co-doped silver peroxide nanozyme-reinforced hydrogel coating is introduced for the prevention of CAUTI. The silicone urinary catheter is modified through a straightforward and cost-effective chemical process to impart multienzyme-like activities, including peroxidase- and catalase-like functions, which exhibit antimicrobial, antibiofilm, and anti-inflammatory properties tailored to the unique urinary tract microenvironment. Additionally, the hydrogel coating enhances the hydrophilicity of catheter, thereby improving patient comfort. In vitro and in vivo experiments substantiate the efficacy of the modified catheter in inhibiting bacterial colonization, curtailing biofilm formation, enhancing oxygen supply, and modulating immune responses. This study not only proposes an alternative strategy for prevention and treatment of CAUTI but also provides a promising therapy that addresses multifaceted therapeutic needs through the utilization of multienzyme-like nanozymes.

Study of biofilm formation among uropathogens isolated from catheter-associated UTI patient from a tertiary care hospital

Background: Catheter-associated urinary tract infection (CAUTI) is a serious health threat and challenging infection. CAUTI accounts for up to 40% of all nosocomial infections. Biofilm provides a survival strategy to microorganisms and ultimately leads to re-infections and recurrence of urinary tract infections (UTI) despite a full course of antibiotics. Aims and Objectives: The present study was conducted to determine the prevalence of CAUTI in suspected UTI patients and prevalence of biofilm-forming uropathogens among CAUTI patients. Materials and Methods: The cross-sectional study was done over a period of 6 months among 95 catheterized CAUTI patients. Biofilm production among isolated uropathogens was tested by tissue culture plate, tube test, and congo red agar method. Isolates were identified as biofilm producer if they were tested positive by any one of the all four methods, and isolates were considered biofilm non-producer in consensus with all four methods. Results: In this study, the prevalence of CAUTI was 68.42%. Among 65 isolates most common uropathogen was 28 (43.07%) Escherichia coli. In this present study, the prevalence of biofilm-forming uropathogens was 58.46% (38). Tissue culture plate was the most sensitive (97.36%) method in detecting biofilm formation followed by modified congo red agar (82.21%), congo red agar (71.05%), and tube test (65.78%). Biofilm productions were significantly associated with female gender, diabetes, and prolonged catheterization. Conclusion: Indwelling urinary catheter acts as a nidus for biofilm formation among microorganisms. Duration of catheterization is inversely associated with UTI. Hence, the need for catheter removal should be assessed daily to prevent infection. Periodic surveillance should be done to detect biofilm formation where prolonged catheterization is inevitable.

Healthcare workers’ compliance with the catheter associated urinary tract infection prevention guidelines: an observational study in Yemen

BackgroundCatheter-associated urinary tract infection is a global problem but it can be prevented with the appropriate implementation of evidence-based guidelines. This study was conducted to assess the level of compliance of healthcare workers with the catheter-associated urinary tract infection prevention guidelines during the insertion of a urinary catheter.MethodsAn observational study using a descriptive cross-sectional design was conducted at Sana’a City hospitals, Yemen. All the nurses and physicians from the governmental, teaching, and private hospitals were eligible to participate in the study. The data collection was performed through convenience sampling from March 2020 to December 2020, using a structured observational checklist prepared specifically for this study.ResultsThe majority of the urinary catheter insertions were performed by nurses. There were no written policy or procedures for an urinary catheter insertion and no in-service education or training departments in the majority of the hospitals. The overall mean score of compliance was 7.31 of 10. About 71% of the healthcare workers had a high or acceptable level of compliance and 29% had an unsafe level of compliance. Compliance was low for maintaining aseptic technique throughout the insertion procedure, using a single use packet of lubricant jelly, performing hand hygiene immediately before insertion, and securing the urinary catheter once inserted. Factors affecting the healthcare workers compliance were gender, the working ward/unit of the healthcare workers, the availability of a written policy/procedure and a department or unit for in-service education.ConclusionYemeni healthcare workers’ overall compliance was acceptable but it was unsafe in several critical measures. There is an urgent need for developing, implementing, and monitoring national guidelines and institutional policy and procedures for catheter-associated urinary tract infection prevention. Periodical in-service education and training programs and adequate access to the necessary materials and supplies are paramount.

Anti-infective Efficacy of Duloxetine against Catheter-Associated Urinary Tract Infections Caused by Gram-Positive Bacteria.

Catheter-associated urinary tract infections (CAUTIs) frequently occur following the insertion of catheters in hospitalized patients, often leading to severe clinical complications. These complications are exacerbated by biofilm-forming organisms such as Staphylococcus aureus, contributing to the emergence of multidrug-resistant (MDR) strains, which complicates treatment strategies. This study aims to investigate the antibacterial, antibiofilm, and antiadhesive properties of duloxetine against S. aureus in the context of CAUTI. Our findings demonstrate that duloxetine exhibits significant antibacterial activity, as evidenced by the agar diffusion method. A minimal inhibitory concentration (MIC) of 37.5 μg/mL was established using the microdilution method. Notably, duloxetine displayed inhibitory effects against biofilm formation on polystyrene surfaces up to its MIC level, as demonstrated by the crystal violet method. Intriguingly, the study also revealed that duloxetine could prevent biofilm formation at lower concentrations and reduce mature biofilms, as confirmed by scanning electron microscopy (SEM) and quantitative biofilm assays. Furthermore, duloxetine-coated silicone catheter tubes exhibited antibacterial properties against S. aureus in a bladder model, visualized by confocal laser scanning microscopy (CLSM) and corroborated through FDA and PI staining, highlighting noticeable morphological changes in S. aureus post-treatment. In conclusion, this study presents duloxetine as a promising alternative agent with antibacterial and antiadhesive properties against S. aureus in the prevention and management of CAUTI, warranting further exploration in the clinical setting.

CAUTI Elimination: A Systematic Elimination of CAUTI in Long-Term Care Facility

Catheter-associated urinary tract infection (CAUTI) in nursing-home residents is commonly associated with multiple problems. Lack of proper intervention to prevent CAUTI in the elderly and frail nursing-home residents leads to sepsis, hospitalization, and antimicrobial use, ultimately causing the colonization with multidrug- resistant organisms (MDROs). Furthermore, it inflates the costs. The project aims to systematically determine an approach to eliminate CAUTI in long-term care facilities. There, the establishment of antibiotic stewardship is at its infancy stage. The CAUTI project contributes significantly to the wide-reaching efforts to reduce the threats posed by antimicrobial-resistant organisms. The crucial element of an impactful strategy is the prevention by utilizing evidence-based bundle of care education and evidence-based urinary catheter protocols (UCP), both funded by the Agency for Healthcare Research and Quality (AHRQ). The CAUTI project’s outcome is measured using National Healthcare Safety Network (NHSN) and the symptomatic definition of CAUTI provided by the Centers for Disease Control and Prevention (CDC) to identify and count the cases in the unit; the team uses the NHSN’s data for benchmarking. The qualitative and quantitative methodology approaches utilized to implement a CAUTI prevention strategy at Burbank Healthcare Center and Rehabilitation. Thirty participants were selected out of 172 populations during the study for the CAUTI project. The findings indicate that 11 out of 30 participants developed CAUTI, of which three acquired it at the facility and eight at the community. Further, although female participants were fewer than males, females seem to develop a CAUTI with higher frequency than male participants.

Strategies to prevent catheter-associated urinary tract infections in acute-care hospitals: 2022 Update.

The intent of this document is to highlight practical recommendations in a concise format designed to assist physicians, nurses, and infection preventionists at acute-care hospitals in implementing and prioritizing their catheter-associated urinary tract infection (CAUTI) prevention efforts. This document updates the Strategies to Prevent Catheter-Associated Urinary Tract Infections in Acute-Care Hospitals published in 2014. It is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the Association for Professionals in Infection Control and Epidemiology (APIC), the American Hospital Association (AHA), and The Joint Commission.

What US hospitals are doing to prevent common device-associated infections during the coronavirus disease 2019 (COVID-19) pandemic: Results from a national survey in the United States.

The ways that device-associated infection prevention practices changed during the coronavirus disease 2019 (COVID-19) pandemic remain unknown. We collected data mid-pandemic to assess the use of several infection prevention practices and for comparison with historical data. Repeated cross-sectional survey. US acute-care hospitals. Infection preventionists. We surveyed infection preventionists from a national random sample of 881 US acute-care hospitals in 2021 to estimate the current use of practices to prevent catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), and ventilator-associated events (VAE). We compared the 2021 results with those from surveys occurring every 4 years since 2005. The 2021 survey response rate was 47%; previous survey response rates ranged from 59% to 72%. Regular use of most practices to prevent CLABSI (chlorhexidine gluconate for site antisepsis, 99.0%, and maximum sterile barrier precautions, 98.7%) and VAE (semirecumbent positioning, 93.4%, and sedation vacation, 85.8%) continued to increase or plateaued in 2021. Conversely, use of several CAUTI prevention practices (portable bladder ultrasound scanner, 65.6%; catheter reminders or nurse-initiated discontinuation, 66.3%; and intermittent catheterization, 37.3%) was lower in 2021, with a significant decrease for some practices compared to 2017 (P ≤ .02 for all comparisons). In 2021, 42.1% of hospitals reported regular use of the newer external urinary collection devices for women. Although regular use of CLABSI and VAE preventive practices continued to increase (or plateaued), use of several CAUTI preventive practices decreased during the COVID-19 pandemic. Structural issues relating to care during the pandemic may have contributed to a decrease in device-associated infection prevention practices.

Knowledge of Nursing Students on Catheter-Associated Urinary Tract Infection Prevention

Catheter-associated urinary tract infections (CAUTIs) are a significant problem in healthcare settings, leading to increased morbidity, mortality, and healthcare costs. Nursing students are crucial in preventing CAUTIs, as they are often responsible for inserting and maintaining urinary catheters in patients. Objective: To assess the nursing students' knowledge regarding the prevention of CAUTIs. Methods: This descriptive cross-sectional was conducted at the Horizon School of Nursing and Health Sciences in Karachi, Pakistan, over a period of two months from November to December 2022. A total of 67 nursing students were recruited using a convenient sampling technique. Data were collected using a self-administered questionnaire that assessed the students' knowledge of CAUTIs. Results: The results showed that 19% of the nursing students had low knowledge, 65% had moderate knowledge, and 16% had a high level of knowledge regarding the prevention of CAUTIs. Conclusions: The findings suggest that most nursing students have moderate knowledge regarding preventing CAUTIs prevention. Educators and administrators can use these findings to develop targeted interventions that address the gaps in knowledge and promote best practices for preventing and managing CAUTIs in nursing students.

Reducing urinary catheter use in geriatric patients - results of a single-center champion-led intervention

BackgroundIndwelling urinary tract catheters (UTC) are a well-known risk factor for urinary tract infections (UTI). Because geriatric patients are at high risk of infection, an intervention with a focus on appropriate and minimal UTC use was introduced in 4 acute care geriatric wards.MethodsBetween 11/2018 and 1/2020, unit-based data on UTC use and nosocomial UTI was collected in accordance with the methods of the German national surveillance system KISS. From 6/2019 to 1/2020, a champion-led intervention was implemented which focused on: (i) feedback of surveillance data, (ii) education and training in aseptic UTC insertion and maintenance, (iii) HCW’s daily assessment of UTC necessity based on a checklist and (iv) timely removal of unnecessary UTCs. UTC use, incidence, and incidence densities for catheter-associated UTI (CAUTI) were calculated before and during the intervention. In addition, we analyzed adherence to a scheduled daily assessment of UTC necessity. Rate ratios (RR) with 95% confidence intervals (95%CI) were calculated. Differences based on the quality of checklist completion were evaluated using the Kruskal Wallis test.ResultsWe analyzed the data of 3,564 patients with a total 53,954 patient days, 9,208 UTC days, and 61 CAUTI. Surveillance data showed a significant decrease in the pooled UTC utilization rate from 19.1/100 patient days to 15.2/100 patient days (RR = 0.80, 95%CI 0.77–0.83, p < 0.001). CAUTI per 100 patients dropped from 2.07 to 1.40 (RR = 0.68, 95%CI 0.41–1.12, p = 0.1279). Overall, 373 patients received a UTC during the intervention. Of those patients 351 patients had an UTC ≥ 2 days. The analysis of these patients showed that 186 patients (53%) received a checklist as part of their chart for daily evaluation of UTC necessity. 43 (23.1%) of the completed checklists were of good quality; 143 (76.9%) were of poor quality. Patients in the group whose checklists were of good quality had fewer UTC days (median 7 UTC days IQR (3–11)) than patients whose checklists were of poor quality (11 UTC days IQR (6–16), p = 0.001).ConclusionWe conclude that a champion-led, surveillance-based intervention reduces the use of UTC among geriatric patients. Further research is needed to determine to what extent the use of checklists in daily medical UTC assessment affects the prevention of CAUTI. The fact that patients whose checklists were completed well had fewer UTC days should encourage a conscientious and thorough daily review of the need for UTC.

Work experience was associated with the knowledge and practice of catheter-associated urinary tract infection prevention among nurses at University of Gondar Comprehensive Specialized Hospital, northwest Ethiopia, 2021

BackgroundCatheter-associated urinary tract infection is the source of about 20% of episodes of health-care acquired infections in acute care facilities and it is over 50% in long-term care facilities. In Ethiopia, there is no published scientific research regarding knowledge and practice of nurses on catheter-associated urinary tract infections prevention. Therefore, this study aimed to assess knowledge, practice and associated factors of CAUTI prevention among nurses working at university of Gondar comprehensive specialized hospital, northwest Ethiopia, 2021.MethodsInstitutional based cross sectional study was conducted at University of Gondar Comprehensive Specialized Referral Hospital from April 01 to May 01, 2021 among 423 nurses. Simple random sampling technique was used. Data were collected by using self-administered questionnaire then coded and entered into EPI- Data version 4.6 and then exported to SPSS version 23. Descriptive statistics was computed, and the result was summarized by texts, tables, and charts. All variables with P-value < 0.25 in the univariate analysis were included in the multivariable regression analysis. The degree of association was interpreted by using the adjusted odds ratio with 95% confidence intervals.ResultsGood knowledge and practice of nurses towards CAUTI prevention was 37.7% and 51.8% respectively. Good knowledge was associated with sex [AOR = 1.84, 95% CI (1.09, 3.11)], work experience [AOR = 2.36, 95% CI (1.09, 5.10)], working unit [AOR = 6.9, 95% CI (2.11, 22.52)], training [AOR = 2.33, 95% CI (1.17, 4.65)] and had guideline [AOR = 2.78, 95% CI (1.59, 4.88)]. Good practice was associated with sex, work experience, attitude and knowledge towards CAUTI prevention [AOR = 2.19, 95% CI (1.23, 3.88)], [AOR = 5.44, 95% CI (1.66, 17.84)], [AOR = 3.06, 95% CI (1.65, 5.67)], and [AOR = 5.28, 95% CI (2.86, 9.76)] respectively.ConclusionsNearly one-third of nurses had good knowledge and more than half of nurses had good practice towards CAUTI prevention. Sex, work experience, work unit, presence of guideline, and training were significantly associated with knowledge. Sex, work experience, good attitude and, knowledge were associated with practice of nurses towards CAUTI prevention. The knowledge and practice towards catheter associated urinary tract infection prevention among nurses should be increased, so that the patients could enjoy and maintain the healthy lifestyle.

Impact of Implementing Key Performance Indicators on Catheter-Associated Urinary Tract Infection (CAUTI) Rates Among Adult ICU Patients in Saudi Arabia

The prevalence of catheter-associated urinary tract infections (CAUTIs) in hospitals characterizes one of the most significant problems in healthcare. This study aims to assess whether the implementation of impact of key performance indicators (KPIs) checklist reduces the number of CAUTI in adults present in intensive care unit (ICU) with indwelling catheters. This is a retrospective analytical study conducted in a tertiary hospital in Riyadh, Saudi Arabia, from June 2020 to June 2021. One hundred and thirty-four patients with CAUTIs met the criteria and were included in the study. Socio-demographic data was collected to enable informed analysis based on personal information (age, gender, marital status, monthly income, level of education, and department) and medical history (duration of catheterization, types of organisms, history of chronic illness, and duration of hospitalization). The research also used a prevention of CAUTI checklist containing 26 items. The outcome measures were 1) the rate of CAUTIs measured pre- and post-implementing performance measurement indicators (KPI) of CAUTIs prevention practice and 2) the prevention of catheter-associated urinary tract infection in three areas: general information recording, insertion practices, and maintenance practices. The study found that there was compliance with the prevention of CAUTIs in terms of recording the general patient's information (72%), insertion practices (52%), and maintenance practices (50%). However, most safety practices, including poor hygiene and safety standards, patient handling, and audited protocol programs, were not strictly followed, resulting in increased risk factors for CAUTIs. Compliance with the prevention of CAUTIs in terms of recording the general patient's information, insertion practices, and maintenance practices lies within the range of 50-75%, and the recommended practices are usually followed. A targeted education on CAUTI-prevention practices curtailing the most aggravating risk factors and adopting a safety culture driven by a patient handling and audited protocol program should be explored to reduce hospital CAUTIs.

Factors Associated With Catheter-Associated Urinary Tract Infection in Patients in the Intensive Care Unit

Catheter-associated urinary tract infection (CAUTI) commonly occurs in intensive care units (ICU) and is associated with longer hospital stays and higher healthcare costs, morbidity, and mortality. The purpose of this study was to examine the factors associated with CAUTI in ICU patients. This study was a secondary analysis of data from a study on the usage of indwelling catheters in adult internal and surgical ICU patients at a teaching hospital in southern Taiwan conducted between January 1 and December 31, 2017. Descriptive analysis, the independent t test, chi-square test, and logistic regression were used to examine the factors associated with CAUTI. Of the 1,120 patients with an indwelling urinary catheter in the ICU, 330 revealed a positive urine culture result, indicating a 29.5% prevalence of CAUTI. The average duration of indwelling urinary catheter usage was 6.55 (SD = 4.89) days. The participants averaged 69.93 years old (SD = 15.19 years), and 627 (56.0%) were men and 493 (44.0%) were women. Being female, having diabetes, having a large indwelling urinary catheter, having a longer duration of indwelling urinary catheter usage, and being unable to remove the indwelling urinary catheter during the ICU stay were found to be associated with a significantly higher risk of CAUTI. Women and patients with diabetes are particularly vulnerable to CAUTI. Thus, urinary catheters should be used with caution. Using smaller-sized urinary catheters and reducing the duration of urinary catheter use are suggested. The results of this study may be used to guide clinical practice to help reduce the incidence of CAUTI and enhance overall healthcare service quality.

Characteristics and outcomes of hospitalised inpatients with indwelling urinary catheter-a retrospective study from a large regional hospital in Queensland

Indwelling urinary catheters (IDCs) are a common invasive device in hospitalised patients. Their use is associated with increased risks of developing catheter associated urinary tract infections (CAUTI), and blood stream infections (BSI). To examine the characteristics and outcomes of adult inpatients with an IDC inserted in hospital and identify risk factors for developing CAUTI and BSI. We performed a retrospective observational study of 430 patients with IDC admitted to medical and surgical units of a leading (tertiary) hospital between Nov 2019 till April 2020. Multiple logistic regression analysis was performed to determine independent risk factors for developing urinary tract infection and blood stream infection. The prevalence of CAUTI in our study was 7.4%. Results of multiple logistic regression indicated that with each day of IDC in situ, the likelihood of UTI development increased by 9% (OR 1.09; 95% CI 1.00 to 1.18; p=0.03). Age, gender, and catheter reinsertion were not associated with UTI development. Longer duration of IDC was associated with elevated risk of developing CAUTI. CAUTI rates were higher than some of those previously published. There was no statistical significance in frequency of CAUTI between medical and surgical patients. No statistically significant variables that contributed to the development of BSI were found. Interventions targeted at reducing catheter days should be used to improve CAUTI rates.

Emergent themes from a quality improvement programme for CLABSI/CAUTI prevention in ICUs amid the COVID-19 pandemic

ObjectivesHealthcare-associated infection (HAI) prevention has been difficult for healthcare providers to maintain during the COVID-19 pandemic. This study summarises themes for maintaining infection prevention activities learnt from the implementation of...

Catheter-Associated Urinary Tract Infection (CAUTI).

One of the most prevalent health-related illnesses globally is catheter-associated urinary tract infection (CAUTI). CAUTIs account for almost half of all hospital-acquired diseases. Most of the healthcare-acquired urinary tract infections result from catheter tubes implantation. These tubes connect a collecting system and the urinary bladder via the urethra. These are known as indwelling urinary catheters. The length of catheterization has a key role in starting bacteriuria since biofilm eventually forms on all of these devices. Despite the low percentage of people with bacteriuria who start showing symptoms, there is nevertheless a significant burden associated with these contamination due to the repeated use of indwelling urinary devices. Minimizing indwelling device usage and stopping the catheter as soon as medically possible are the two most crucial preventative measures for bacteriuria and infection when device use is required. Efforts to avoid catheter-acquired urinary infections must be implemented and monitored by infection control guidelines in healthcare institutions. These approaches include monitoring device use, the suitability of device justifications, and problems. Ultimately, technological advancements in device substances that inhibit colony generation will be necessary to avoid these infestations. There is still some way by which we can bring down the increased phenomenon of catheter-associated urinary tract contamination by maintaining hygiene while handling the catheter and patients and keeping the infected patients away or isolated from unaffected patients as a precaution. This article mainly focuses on an overview that helps with discussing prevention, risk factors, diagnosis, control and management of CAUTI.

A MULTIDISCIPLINARY TEAM APPROACH FOR PREVENTION OF CATHETER-ASSOCIATED URINARY TRACT INFECTIONS IN THE ICU

A MULTIDISCIPLINARY TEAM APPROACH FOR PREVENTION OF CATHETER-ASSOCIATED URINARY TRACT INFECTIONS IN THE ICU

Bacteriological Profile of Clinical Isolates from Urinary Samples and Prevalence of CAUTI at a Tertiary Care Hospital

Background: Urinary tract infections (UTIs) attributed to the use of an indwelling catheter is one of the most common infections acquired by patients in health care facilities. This infection is associated with varied microbiological etiology. Catheter-associated urinary tract infection (CAUTI) is an important cause of morbidity and mortality in India. The objective of this study was to find the prevalence of CAUTI infection and to determine their antibiotic profile. Aims and Objectives: The aim of the study was to provide a baseline information in the context of culture positivity rate of urinary isolates and prevalence of catheter associated urinary tract infections (CAUTI), to identify the associated microbial, and to determine their susceptibility pattern to commonly used antimicrobial agents for prophylactic and empiric therapy. Materials and Methods: This prospective study was done on nonrepetitive urine samples from all age group patients of both inpatient and outpatient department. Semi quantitative bacterial culture was performed, and isolates were identified and antimicrobial sensitivity tests were carried out by Vitek-2 compact automated method. Results: Significant bacteriuria was observed among 257/1543 (16.65%) urine samples. Among bacterial isolates, Gram negative bacilli predominate. Escherichia coli 7/17 (44%) being the most common isolate followed by Klebsiella (35%). The incidence of CAUTI/1000 catheter days observed in our study was 2.77. Total 3 CAUTI were identified from July 2021 to June 2022, out of which 2 were Klebsiella pneumoniae and 1 isolate was Enterococcus faecium. Conclusions: Uropathogens from CAUTI patients exhibit significantly higher resistance to most antibiotics than non- CAUTI isolates. This is an important factor to take into consideration when choosing correct treatment options for patients with urinary tract infection. Klebsiella pneumoniae is one of the important notable pathogens causing nosocomial infections.............

Healthcare Providers’ Compliance with Guidelines for Catheter-Associated Urinary Tract Infections in a Rural Teaching and Referral Hospital

Introduction: Healthcare professionals (HCPs) play a key role in the prevention of catheter-associated urinary tract infections (CAUTI). This study aims to determine the compliance of healthcare personnel with urethral catheterisation standards and the factors affecting it. Materials and Methods: This study is a prospective survey and was conducted between February and March 2021 after ethical approval and patient consent. An internet-based, structured 39-item questionnaire was sent via email to all HCPs at Zonguldak Bulent Ecevit University Hospital, Zonguldak, Turkey. A to evaluate their knowledge and attitudes towards the prevention of CAUTI. The questionnaire was completed by 156 health professionals. For categorical parameters Fisher’s exact test, though for scale parameters student t-test, Mann–Whitney U and Kruskal–Wallis tests were used. All statistical analysis was done using SPSS 17.0. Results: The average years of experience of the HCPs who participated in the survey was 12.5 years. The level of knowledge of the doctors and the nurses about the indication of catheter insertion was similar, whereas the level of knowledge about CAUTI prevention was higher among the doctors. However, none of the participants could fully describe how to prevent CAUTI. Conclusions: The level of knowledge of CAUTI preventive measures among the participants was insufficient. To effectively preventing CAUTI, there is a need to change HCPs’ perspective on this issue, which can be achieved through training, and advantage current technologies.

Knowledge, Practice and Associated Factors of Health Care Workers on Prevention of Catheter-Associated Urinary Tract Infections in South Wollo Zone Public Hospitals, Northeast Ethiopia.

IntroductionHealth care providers are responsible for inserting and maintaining urinary catheters. Hence, it is very important that health care professionals need to be skillful and knowledgeable to prevent urinary tract infection for those patients undergoing indwelling catheter. Thus, this study aimed to assess knowledge, practice and associated factors of health care workers on prevention of catheter-associated urinary tract infections in South Wollo zone public hospitals, Northeast Ethiopia.MethodsAn institution-based cross-sectional study design was employed by using a simple random sampling technique among 413 health care workers. Data were entered into Epi-Data version 4.6 and were exported to SPSS version 26 for analysis. Bivariable logistic regression analyses were performed, and variables with P-value less than 0.25 were fitted to multivariable logistic regression. In multivariable regression analysis, variables having p-value <0.05 were declared as significant factors for outcome variable.ResultsOut of the total 413 health care workers, 298 (72.2%) had adequate knowledge and 233 (56.4%) had adequate level of practice towards catheter-associated urinary tract infection prevention. Received training [AOR = 2.33, 95% CI: 1.404–3.889] and being bachelor degree holder [AOR = 1.90, 95% CI: 1.084–3.359] were significantly associated with adequate knowledge. On the other hand, being master and doctor [AOR = 4.71, 95% CI: 1.768–12.56], adequate level of knowledge [AOR = 2.90, 95% CI: 1.785–4.723], received training [AOR = 2.09, 95% CI: 1.315–3.338] and work experience ≥20 years [AOR = 5.82, 95% CI: 1.497–22.69] were significantly associated with adequate level of practice.ConclusionA substantial proportion of health care workers had inadequate knowledge and practice towards catheter-associated urinary tract infection prevention. Therefore, health care workers should strictly follow infection prevention guidelines and should update their knowledge and practice by taking short and long term training.

Implementing Infection Prevention and Control (IPC) Practices Including COVID-19 Mitigation Strategies in a Skilled Nursing Facility

BackgroundThe All Facilities Letter (AFL) issued by the California Department of Public Health (CDPH) on November 9, 2020, informed all skilled nursing facilities (SNFs) of the passage of AB 2644 (Chapter 287, Statutes of 2020). This AFL requires SNFs to have a full-time, dedicated infection preventionist (IP), a plan for infection prevention, quality control, and annual infection prevention and control training for all healthcare personnel (HCP). Healthcare facilities are ideal settings for transmitting infections to residents, healthcare workers, their families, and communities.Therefore, the objective was to assess compliance with infection prevention and control and standardized practices in Hand Hygiene, Personal Protective Equipment (PPE) donning and doffing, and Catheter-Associated Urinary Tract Infection (CAUTI) prevention bundle.MethodsHand Hygiene, PPE, and CAUTI competencies were developed to increase awareness and compliance with standardized practices. Hand Hygiene and CAUTI champions representing every shift in the unit were created to lead SNF staff in observing IPC practices. A direct observation tool was utilized to gather data, and just in time, feedback was provided to staff when opportunities in non-compliance were identified.ResultsThe compliance rate in Hand Hygiene, PPE, and CAUTI prevention in 11 months increased from 69 % to 99 %.ConclusionsInfection Prevention and Control practices are the most critical element in reducing healthcare-associated infection among residents and staff. Implementing IPC practices increased compliance in Hand Hygiene, PPE, and CAUTI prevention bundle. Comprehension of fundamental IPC practices is critical to health care systems, especially during a pandemic.