Urinary Catheter Care Research Articles

Urinary Catheter Care Approach for Urinary Tract Infection among Nurses in Tertiary Care Hospital

Urinary tract infections (UTIs) are the most common infection in hospital setting, the period of hospital-derived waste that affects individuals today. A significant number of seventy-five percent of urinary tract infections acquired in the hospital are associated with the use of a permanent bladder catheter (IDC), considering that there are about 15-25% chance of an inpatient requiring catheter insertion during your stay [1].

Care Bundles for Preventing Device Related Infections: Just Focus on These 6 Things

Background: Centralizing healthcare associated infection (HAI) data for 21 hospitals across several states facilitates a big picture assessment of monthly enterprise performance along with evaluation of practice, policy, and products. Variation in prevention practices has made it difficult to identify areas of focus and created confusion when attempting to standardize prevention tactics for central-line and urinary catheter care. Lack of consistent practice audits have made it difficult to evaluate actual practice. For these reasons, we performed a gap analysis to understand the current state. Methods: Gap assessment tools were developed to assess infection prevention practices for central lines and indwelling urinary catheters. Survey questions were developed with a comment option to collect qualitative data. The 2014 Compendium of Strategies to Prevent Healthcare-Associated Infection in Acute-care Hospitals was utilized as the reference point. This document facilitates the translation of essential information into clinical practice, thus providing the rationale and level of evidence needed for discussion groups. Completion occurred with various key stakeholders within each hospital. One survey per hospital was compiled. Results: All hospitals completed the survey with key themes emerging and supported by observational data. Findings included variation with education, chlorhexidine bathing, types of dressings, and compliance with alcohol port protectors. Gaps identified with urinary catheter care included confusion surrounding catheter care, breaches in seals, and optimizing alternatives to catheterization. Rather than segment solutions for identified gaps, care bundles were developed to provide focus, to facilitate evidence-based practice, and to create standard work-around clinical audits that consisted of going to the patient rather than the electronic health record. Care bundles provided the 6 items to focus on and for which to create policy and standardize products. Conclusions: Care-bundle implementation initially created resistance from clinicians and many questions regarding actual practice. The design of the tool was deliberate in that audit language, the metric, and the “why” were included and served as a medium to discuss the evidence and immediate feedback for practice. Pareto charts were posted on unit performance boards. It became evident that compliance with prevention tactics was not consistent. Although number of infections or outcome data did not appreciably decrease, standardized utilization ratio was reduced by 11% for each device after 3 quarters. Process measures from bundle audits continue to improve, as do observational data, and these are part of focused discussions at quality forums. A culture change has occurred as process measures and evidence-based practice has become a priority.Funding: NoneDisclosures: None

Quality Initiative to Reduce Catheter-Associated Urinary Tract Infections Using Cleansing Cloths With a Standardized Method

Background: Catheter-associated urinary tract infections (CAUTIs) account for >15% of hospital-acquired infections, resulting in increased length of stay and costs. Consequently, methods to improve indwelling urinary catheter (IUC) care and maintenance are warranted to reduce the risk of hospital-acquired CAUTIs. This study was a prospective quality improvement (QI) project to reduce CAUTIs using prepackaged cloths (ReadyCleanse by Medline Industries) and a simple, standardized cleaning process for care and maintenance of IUCs. Methods: This study is an ongoing QI project at NorthShore University HealthSystem, a 4-hospital system located north of Chicago, Illinois, with 750 beds and ∼64,000 annual admissions. The study consists of a 1.5-month staff training on proper product use (phase 1), followed by an intervention using the cloths for IUC care (phase 2). Each package contains 5 individual cloths corresponding to a simple, 5-step, cleansing protocol. IUC care and maintenance are performed twice daily on a routine basis and after each incontinent episode. Beginning July 2018, current practice (soap and wash cloth) was replaced with the ReadyCleanse cloths, and on August 1, 2018, data collection began. Adult patients admitted at all 4 NorthShore Hospitals with an IUC for >24 hours are enrolled in the study. From patient electronic health records, we collected patient demographics, reason for IUC insertion, days of catheter use, and development of CAUTI (according to the NHSN definition). During the intervention, observations of compliance and performance of catheter care were also performed. For the analysis described here, results for the first 14 months of the study were compared to CAUTI numbers from the 14-month period prior to the start of the study (February 2017–March 2018); the data presented represent ∼50% of the planned data collection. Results: As of September 30, 2019, 4,969 patients were prospectively enrolled in the study: 1,491 patients from hospital A, 1,451 from hospital B, 1,091 from hospital C, and 936 from hospital D. Patient demographics for the study cohort were 47% female, with a median age of 77 years and an average of 3.9 catheter days per patient. Systemwide, observational audits for compliance using the cloths averaged 95%. Upon completion of study month 14, 22 CAUTIs had been identified, compared to 26 CAUTIs for the comparison period, indicating a 15% reduction. Conclusion: Implementation of this simple, standardized alternative for IUC care is feasible on a large scale and may have potential for reducing CAUTI rates.Funding: Medline Industries supported this study.Disclosures: None

System Culture Change Decreases CAUTI

<h3>Background</h3> Across the healthcare system, catheter associated urinary tract infection (CAUTI) rates were escalating and the organization was not meeting goals. Facility assessments revealed; indwelling catheter placement without medical necessity, lack of alternative device use, broken sterile technique during insertion, improper maintenance, and unnecessary catheter longevity. Improvements in standardization of products, insertion techniques, and the development of nurse driven standing orders for removal were needed to eradicate system wide CAUTI. <h3>Methods</h3> A steering committee was formed and lead by a Chief Nursing Officer and Clinical Practice Specialists. A multidisciplinary team was developed consisting of fourteen facility leads, Clinical Nurse Educators, bedside nurses, Infection Prevention, Quality Improvement, data analysists, and sourcing representatives. Following in-depth review of CAUTI cases and analysis of the data, several evidence based practice CAUTI reduction strategies were implemented including, product standardization, focused education/validation, indwelling urinary catheter care teams (UCCT), buddy system, standardization of process including utilization of necessity forms, placement checklists, audit tools, and data collection. <h3>Results</h3> The nurse driven system CAUTI eradication plan has been successful. The incidence of CAUTI has decreased 27.8% from 2015-2019 with the initiation of an evidence based plan. Routine placement of indwelling urinary catheters has declined. Alternative device use has increased. Sterile technique during insertion has improved with the use of validated catheter teams and the implementation of the buddy system. Product Life Cycle Assessments conducted in 2017 and 2019 have demonstrated improvements related to indwelling catheter use and care. While the goal of eradication has not yet been achieved, the system has decreased CAUTIs drastically and continues to assess for areas for improvement. <h3>Conclusions</h3> Eradication of CAUTI aligns with the mission, vision and values of the organization. A system wide culture change based on evidence based practice, led by nursing leadership and all levels of nursing, has decreased CAUTIs in a large healthcare system.

CAUTI Eradication Through System Culture Change

<h3>Background</h3> Across the healthcare system, catheter associated urinary tract infection (CAUTI) rates were escalating and the organization was not meeting goals. Facility assessments revealed; indwelling catheter placement without medical necessity, lack of alternative device use, broken sterile technique during insertion, improper maintenance, and unnecessary catheter longevity. Improvements in standardization of products, insertion techniques, and the development of nurse driven standing orders for removal were needed to eradicate system wide CAUTI. <h3>Methods</h3> A steering committee was formed and lead by a Chief Nursing Officer and Clinical Practice Specialists. A multidisciplinary team was developed consisting of fourteen facility leads, Clinical Nurse Educators, bedside nurses, Infection Prevention, Quality Improvement, data analysists, and sourcing representatives. Following in-depth review of CAUTI cases and analysis of the data, several evidence based practice CAUTI reduction strategies were implemented including, product standardization, focused education/validation, indwelling urinary catheter care teams (UCCT), buddy system, standardization of process including utilization of necessity forms, placement checklists, audit tools, and data collection. <h3>Results</h3> The nurse driven system CAUTI eradication plan has been successful. The incidence of CAUTI has decreased 27.8% from 2015-2019 with the initiation of an evidence based plan. Routine placement of indwelling urinary catheters has declined. Alternative device use has increased. Sterile technique during insertion has improved with the use of validated catheter teams and the implementation of the buddy system. Product Life Cycle Assessments conducted in 2017 and 2019 have demonstrated improvements related to indwelling catheter use and care. While the goal of eradication has not yet been achieved, the system has decreased CAUTIs drastically and continues to assess for areas for improvement. <h3>Conclusions</h3> Eradication of CAUTI aligns with the mission, vision and values of the organization. A system wide culture change based on evidence based practice, led by nursing leadership and all levels of nursing, has decreased CAUTIs in a large healthcare system.

Barriers and facilitators to implementation of a multifaceted nurse-led intervention in acute care hospitals aimed at reducing indwelling urinary catheter use: A qualitative study.

It is essential to evaluate the ways in which practice changes are implemented and received in and across contexts, identifying barriers and enablers, and mechanisms for enhancing success. To provide insights into the experiences of clinicians in implementing a multifaceted bundled urinary catheter care intervention in four acute care hospitals in New South Wales, Australia. The catheter care bundle was implemented using a pre- and postintervention study design. The intervention was implemented in all adult inpatient wards, emergency departments and operating theatres of four hospitals. The bundle consisted of an integrated set of evidence-based practices to assist clinicians in making better informed decisions related to catheter insertion, care and removal practices. Focus groups at each participating hospital evaluated the implementation processes from the clinicians' perspective, identifying barriers and enablers to successful implementation. Eight focus groups were held with 35 participants. Four key inter-related themes were identified: early and sustained engagement with key stakeholders; good planning but remaining flexible; managing the burden of practice change; and adopting and sustaining practice change. These themes capture and highlight the complexity and the challenges associated with implementation of the practice change across contexts and the project timeline. It is imperative to understand the challenges associated with complex practice change and ways in which implementation can be optimised. This study identified barriers and enablers experienced by staff implementing the bundled intervention. The themes encapsulate factors central to success of practice change within the complex, multilayered healthcare environment. Key challenges highlight the need for forward planning, strategic engagement of key players, continuing monitoring and feedback together with adequate resourcing tailored to result in sustainable normalisation of the intervention over time. The COREQ checklist for qualitative studies has been used in reporting this study.

Diagnosis, prevention and control of urinary tract infections: a survey of routine practices in Belgian nursing homes.

Urinary tract infections (UTIs) are one of the most frequently reported infections in older adults and the most common reason for antimicrobial prescribing in nursing homes (NHs). In this vulnerable population, both a good diagnosis and prevention of these infections are crucial as overuse of antibiotics can lead to a variety of negative consequences including the development of multidrug-resistant organisms. To determine infection prevention and control (IPC) and diagnostic practices for UTIs in Belgian NHs. Local staff members had to complete an institution-level questionnaire exploring the availability of IPC practices and resources and procedures for UTI surveillance, diagnosis, and urinary catheter and incontinence care. UTIs were the second most common infections in the 87 participating NHs (prevalence: 1.0%). Dipstick tests and urine cultures were routinely performed in 30.2% and 44.6% of the facilities, respectively. In non-catheterised residents, voided or midstream urine sampling was most frequently applied. Protocols/guidelines for urine sampling, urinary catheter care and incontinence care were available in 43.7%, 45.9% and 31.0% of the NHs, respectively. Indwelling catheters were uncommon (2.3% of the residents) and urinary retention (84.9%) and wound management (48.8%) were the most commonly reported indications. Only surveillance was found to significantly impact the UTI prevalence: 2.2% versus 0.8% in NHs with or without surveillance, respectively (P < 0.001). This survey identified key areas for improving the diagnosis and prevention of UTIs, such as education and training regarding the basics of urine collection and catheter care.

592 Prevention of CAUTIs in a Burn ICU

Abstract Introduction Catheter-associated urinary tract infections (CAUTIs) are the most common hospital-associated infection (HAI). Urinary catheter use is associated with urinary tract infections (UTIs) that can lead to complications such as cystitis, pyelonephritis, bacteremia, septic shock, and death. CAUTIs are associated with an excess length of stay of 2–4 days, increase costs of $0.4–0.5 billion per year nationally, and lead to unnecessary antimicrobial use. Through numerous implementations, a Burn ICU was able to drastically decrease their incidence of CAUTIs. Methods A Burn ICU implemented several interventions to reduce CAUTI rates. These interventions included: Results When this project was initiated in September of 2017, there were 9 CAUTIs identified in a Burn ICU, per the hospital’s Infection Prevention Department. By the end of 2017, there were 11, which equated to a rate of 14.67 per 1000 urinary catheter days. In 2018, the Burn ICU had 1 CAUTI, with a rate of 1.92 per 1000 urinary catheter days. In 2019 (through quarter 2), the Burn ICU has not had a CAUTI per the Infection Prevention Department. We believe the interventions made have drastically decreased the incidence of CAUTIs. Conclusions A Burn ICU implemented many new practices in 2017 when the CAUTI rate and SIR were above the hospital’s overall SIR. The Burn ICU staff now practice proper care and maintenance of urinary catheters and continue to provide excellent care. Although we have decreased our incidence of CAUTIs for 2018 and 2019, it is equally important we sustain this improvement. Therefore, we will continue to provide an open forum for discussion with staff so we can all do our part in keeping patients safe. Applicability of Research to Practice A Burn ICU decreased the incidence of CAUTIs by educating staff on proper care and maintenance of urinary catheters, removing catheters as soon as possible, and testing for UTIs upon admission to determine the patient’s baseline. By doing so, CAUTI rates went from 14.67 to 0 per 1000 urinary catheter days.

818 A Themed Approach to Decreasing CAUTI

Abstract Introduction In 2017 a high incidence of Catheter Associated Urinary Tract Infection (CAUTI) was recognized in the burn unit. Initially, when there were 4 CAUTIs recognized, analysis of the factors that led to the CAUTIs was done by the practice council and leadership team. Methods Initially, education specific to burn catheter use and areas of improvement was disseminated and included the CDC’s research on biofilm formation, variables that cause CAUTI, and the key factors to prevent CAUTI. This was followed by a test to assess for knowledge retention. In addition, one on one education was provided to each Burn staff member to ensure appropriate performance and documentation of insertion, pericare, urinary catheter care, and the significance of discontinuation of urinary catheter utilization at the earliest possible time. This education was then disseminated in a hospital wide campaign called “CAUTI Task Force: May the “Force” be with us”. This was a Star Wars themed initiative that featured a video of Star Wars clad task force members battling the CAUTI. Emphasis was placed on pericare, documentation, and decreasing the urinary catheter standard utilization ration based on a hospital acceptable reasons to continue catheter use. Urinary catheter utilization was addressed by staff daily at morning multidisciplinary rounds. Self-audits and audits by nursing leadership were performed to evaluate for improvement of the main education points of pericare, documentation, and early urinary catheter removal/necessity of catheter use. Results Successes were noted by continuing to count how many weeks since the last CAUTI and were celebrated with “Pee Parties” that had yellow themed food and drinks. A total of 36.5 weeks (8.5 months) without a CAUTI was recognized at 12 weeks and at 6 months. Ultimately, here was a reduction in CAUTIs from 6 in 2017 to 1 in 2018. The standard utilization ratio for catheter use decreased from 1.66 in 2017 to 1.18 in 2018. Conclusions There was great momentum and staff interest in the Star Wars theme and the recognition with “Pee Parties”. Further work is ongoing to decrease the standard utilization ratio for catheter use to below 1. This initiative has continued into 2019 to add other methods to reduce utilization use of a hospital wide data tool to detect usage of catheters in place longer than 4 days. Applicability of Research to Practice The interventions chosen were all focused on increased awareness, focus, and placing importance on improving a problem that nurses knew was harmful to their patients. There were negligible costs other than staff time for implementation, audits, and education. The results achieved are statistically significant. The implementation had great benefit with little risk. Engagement and entertainment helped to increase nurse retention and focus on the actions that would achieve results.

Prevalence survey on catheter-associated urinary tract infection (CAUTI) in public hospitals in Hong Kong 2018.

We conducted a survey of 16,914 patients to determine the point prevalence of healthcare-associated catheter-associated urinary tract infection (HA-CAUTI) and urinary catheter care in public hospitals in Hong Kong. Overall HA-CAUTI prevalence was 0.27%. Compliance was generally good, except for documenting the date of planned removal and securing the catheter properly.

Urinary Catheter Management Approaches Among Women Undergoing Benign Gynecologic Surgery: A Randomized Trial.

The objective of this study was to identify differences in voiding trial success rates between delayed (postoperative day 1) and day of surgery catheter removal ("fast track") among women undergoing benign gynecologic surgery. Rates of urinary tract infection, patient satisfaction, and lower urinary tract symptoms were compared between catheter management schemes. Women undergoing benign gynecologic surgery were randomized to either "conventional" delayed urinary catheter care removal on postoperative day 1 or day of surgery catheter removal (fast track) 4 hours after surgery. Subjects were asked to complete a brief survey recording bladder function before and during their hospitalization and satisfaction with their catheter management. Subjects were contacted by phone 2 to 3 weeks after the index surgery to survey their bladder function including symptoms (eg, dysuria) or treatment indicative of a bladder infection. The median dwell time for Foley catheters in the "fast-track" group was 8.15 hours (SD = 375 minutes), whereas the median dwell time in the conventional group was 20.6 hours (SD = 265 minutes), which was significantly different (P < 0.001). Overall, 153 (93%) patients passed their voiding trial with significantly more patients passing their voiding trial in the conventional management group (P = 0.01). There was no difference in the Urogenital Distress Inventory scores at 2 weeks between catheter management cohorts (P = 0.81). Foley dwell time is significantly reduced in the fast-track cohort. Voiding trial failure is higher with same-day catheter removal but that rate of failure rate is low. Patient satisfaction, the Urogenital Distress Inventory score, and postoperative urinary tract infection rates are not significantly different between cohorts.

514. Shedding of Multidrug-Resistant Gram-Negative Bacilli by Colonized Patients during Procedures and Patient Care Activities

BackgroundContaminated environmental surfaces contribute to transmission of healthcare-associated pathogens such as multidrug-resistant gram-negative bacilli. We hypothesized that medical procedures and patient care activities facilitate environmental dissemination of multidrug-resistant gram-negative bacilli in hospitalized patients.MethodsWe conducted a cohort study of hospitalized patients in contact precautions for carriage of extended-spectrum β-lactamase (ESBL)-producing or carbapenem-resistant gram-negative bacilli (CR-GNB) to determine the frequency of environmental shedding during procedures and care activities. Perirectal, wound, and skin were cultured for the gram-negative bacilli of interest. Prior to each procedure or activity, surfaces in the room and portable equipment used for procedures were disinfected. After procedures, high-touch surfaces and portable equipment were cultured; negative control cultures were collected after 1 hour in the absence of a procedure.ResultsOf 60 participants, 38 (63%) were in contact precautions for ESBL-producing gram-negative bacilli and 22 (37%) for CR-GNB. Thirty-four (57%) participants had positive perirectal, wound, or skin cultures. Contamination of surfaces with the colonizing multidrug-resistant gram-negative bacilli occurred frequently during procedures and activities such as wound care, assistance with meals, and urinary catheter or colostomy care (11% to 29% of procedures/activities), whereas contamination was rare in the absence of a procedure (1%). Contamination was recovered from 6 of 56 (10%) portable devices used for procedures.ConclusionEnvironmental shedding of multidrug-resistant gram-negative bacilli occurs frequently during medical and non-medical procedures in hospitalized patients. Our results suggest that there is a need for effective strategies to disinfect surfaces and equipment after procedures.Disclosures All authors: No reported disclosures.

Navel to Knees With Chlorhexidine Gluconate

Urinary tract infections are the most common type of health care-associated infection, and greater than 75% of them are attributed to an indwelling urinary catheter. A catheter-associated urinary infection may lead to a longer hospital length of stay by as many as 4 days. A new patient care standard requiring twice-daily chlorhexidine cleansing from umbilicus to knees was implemented on all patients of the pilot unit with a urinary catheter. This same technique was used after a patient with a urinary catheter had an incontinent bowel movement. The 9-month average catheter-associated urinary infection rate decreased from 3.06/1000 urinary catheter days to 0.46/1000 urinary catheter days after implementation of the new standard. The use of chlorhexidine for routine urinary catheter care and after bowel movements from umbilicus to knees for patients with urinary catheters may significantly decrease catheter-associated urinary tract infections when compared with the standard of care using soap and water. Standards for Quality Improvement Reporting Excellence guidelines were used in reporting these data.

Knowledge and Practices among Female Nurses on Insertion and Care of Indwelling Urinary Catheter to Female Patients in a Selected Teaching Hospital in Sri Lanka

Globally, catheter-associated urinary tract infection (CAUTI) is one of the most common hospital-acquired infections. By following proper guidelines and recommended practice regarding insertion and care of indwelling urinary catheter, one could prevent and reduce CAUTI. Knowledge and practices among nurses regarding the insertion and care of indwelling urinary catheter in female patients are highly essential to minimize complications related to indwelling urinary catheter among female patients. There are limited data available on this phenomenon in Sri Lanka. The purpose of this study was to determine knowledge and practices among nurses regarding the insertion and care of indwelling urinary catheter in female patients at a selected teaching hospital. A descriptive cross-sectional design was conducted among conveniently selected 122 nurses from a teaching hospital. A pre-tested (n=10), a semi-structured questionnaire, was used to collect data. Ethical approval was obtained from the ethics review committees of the Faculty of Medical Sciences, University of Sri Jayewardenepura, and Colombo South Teaching Hospital, Sri Lanka. Findings revealed that only 36% of the participants had a satisfactory level of knowledge on indwelling urinary catheter insertion. Most of the participants (79.5%) had a satisfactory level of practices regarding indwelling urinary catheter insertion. Majority of the participants (82%) had an unsatisfactory level of knowledge regarding indwelling urinary catheter care. Most of the participants (78.7%) had a satisfactory level of practices regarding indwelling urinary catheter care. In conclusion, the majority of the participants had an unsatisfactory level of knowledge regarding indwelling urinary catheter insertion and care. There is a need for education on indwelling urinary catheterization and care for nurses in Sri Lanka.

Postoperative Urinary Tract Infection Quality Assessment and Improvement: The S.T.O.P. UTI Program and Its Impact on Hospitalwide CAUTI Rates

Postoperative urinary tract infection (UTI) is a frequent complication that diminishes patient experience and incurs substantial costs. The purpose of this project was to develop a urinary tract care assessment tool that would lead to actionable quality improvement initiatives. Multidisciplinary teams at a single institution developed the S.T.O.P. UTI algorithm to assess elements related to urinary catheter care: Sterile catheter placement, Timely catheter removal, Optimal collection bag position, and Proper urine sampling for urinalysis and culture. Based on this evaluation, a targeted intervention was applied to address deficient areas in surgical patients. UTI rates were monitored. The assessment revealed that best practice for sterile placement was being performed but that time to removal, optimal positioning, and proper sampling could be improved. Providers were educated on best practice for catheter removal, nurses placed a reminder note on the chart, personnel were taught about optimal catheter positioning, and nursing assistants were educated on best practices for collection of urine. From 2012 to 2015, non-risk-adjusted UTI rates in surgical patients decreased from 2.90% to 0.46% (p = 0.0003), and the American College of Surgeons National Surgical Quality Improvement Program risk-adjusted comparison improved from the 8th to the 4th decile. Simultaneously, hospitalwide catheter-associated UTI rates also decreased, from 2.24/1,000 catheter-days in 2014 to 0.70/1,000 catheter-days in 2016 (p < 0.001). The S.T.O.P. UTI algorithm is a tool that hospitals can use to systematically assess UTI processes. The program can identify areas for improvement specific to an institution, directing the allocation of quality improvement resources to decrease both surgical and medical UTIs.

Competence of Novice Nurses to Enter Nursing Practice as Perceived by Ward Incharges

Competence of novice nurses may vary and it affects the quality of nursing care provided by them. The present study was conducted to find the competence of novice nurses to enter nursing practice as perceived by ward incharges of selected hospitals. Theoretical framework of the study is based on Patricia Benner’s theory Novice to Expert. Quantitative research approach with descriptive design was used for the study. The sample comprised of 120 ward incharges from selected hospitals. The tool used was a scale to find the competence of novice nurses as rated by ward incharges. The study revealed that ward incharges perceived novice nurses to be fairly competent to care for 2 - 3 patients and only a few were competent to care for 4 - 5 patients at a time. Majority of novice nurses were competent in basic hygienic care, vital sign assessment, oral medication, IV push, GRBS, pulse oximetry and oxygen administration via mask, Ryle’s tube insertion, feeding and its removal, urinary bladder catheterisation and catheter care, infected wound dressing, suture removal, and drain removal. Few novice nurses were not competent in basic hygienic care, vital sign assessment, IM injection, blood draw/ venipuncture, Ryle’s tube feeding and its removal, and catheter care. The competency of novice nurses was least in colostomy care followed by Ryle’s tube insertion, infected wound dressing, urinary bladder catheterisation, drain and suture removal.

Presentation Number EPOP-16 - Standardizing Urinary Catheter Care and Maintenance in the Intensive Care Unit

Background: A catheter-associated urinary tract infection (CAUTI) is a preventable infection that has a significant impact on patient outcomes and hospital reimbursement. In 2016, our 394-bed acute care facility saw an increase in CAUTI occurrences in the intensive care unit (ICU). The objective of this process improvement project was to decrease the incidence of ICU CAUTI.

Knowledge on Practice of Urinary Catheter Care and Compliance to Urinary Catheter Care Guidelines-A Hospital based Study

Background: Catheter associated urinary tract infections are the leading cause of secondary health care-associated bacteremia. An infection that involves any of the organs or structures of urinary tract infection including the kidneys, urethra, bladder and ureter is called as urinary tract infection. About 75% of urinary tract infections acquired in the hospital are because of the urinary catheters. Prolonged use of indwelling urinary catheter is one of the main risk of catheter associated urinary tract infection. Objective: To assess the knowledge on practice of urinary catheter care and compliance to urinary catheter care guidelines by the staff nurses. Materials and Method: Quantitative approach with descriptive survey design was used for the study. Staff nurses available during data collection and willing to participate were included. Purposive sampling technique was used to recruit the participants to assess the knowledge. By concealed observation practices of urinary catheter care were made to assess the compliance. Results:Majority 89(82.4%) of the participants had average knowledge, 18(16.7%) had good knowledge on prevention of catheter associated urinary tract infections. There was maximum noncompliance to the procedural steps while performing urine specimen collection, removal of urinary catheter and maintenance of urinary catheter. Conclusion:Nurses have to be aware of hospital policies and CDC guidelines in carrying out procedures like urinary catheter insertion, collection of urine specimens and maintenance of indwelling urinary catheter. Compliance of staff nurses is vital in reducing and preventing the occurrence of health care associated infection.

Effect of Protocol of Care of Patients Undergoing Urinary Catheterization on Nurses, Knowledge

Background: The indwelling urinary catheter (IUC) is a widely utilized device in modern hospital environments, yet they are not always used appropriately in hospital settings and can result in prolonged use and improper management, increasing risk of infections and length of stay. Hence, professional must have knowledge related to the management of urinary catheterization. Aim of the study was to evaluate the impact of protocol of care of patients undergoing urinary catheterization on nurses, knowledge. Subjects and Method: A quasi- experimental research design was used to conduct this study. The study was carried out at Intensive Care Unit, Urology Department and Department of Internal Medicine at Al-Azhar University hospital in Damietta City to test the hypotheses that positive changes in nurses' knowledge after implementing the protocol of care for patients undergoing urinary catheterization. A convenient sample of 50 nurses was included. One tool was used for data collections, part (1) Structured Interview Questionnaire tool that includes demographic data part (2) Nurse's Knowledge Assessment tool, to assess nurse's Knowledge about urinary catheterization and urinary catheter care Results: demonstrated that there were statistically significant improvements in the total score of nurses' knowledge regarding care of patients undergoing urinary catheterization throughout the protocol intervention . Recommendations: The study recommended that providing ongoing in-service education for nurses to update their knowledge related to care of patients undergoing urinary catheterization and catheter –associated problems.

Nurses' Application of Infection Control Measures related to Urinary Catheter Care

Nurses' Application of Infection Control Measures related to Urinary Catheter Care