Catheter-associated urinary tract infections in intensive care units can be reduced by prompting physicians to remove unnecessary catheters.
Infect Control Hosp Epidemiol
; 25(11): 974-8, 2004 Nov.
Article
em En
| MEDLINE
| ID: mdl-15566033
ABSTRACT
OBJECTIVE:
Indwelling urinary catheters are the most common source of infections in intensive care units (ICUs). The aim of this study was to evaluate the efficacy of nurse-generated daily reminders to physicians to remove unnecessary urinary catheters 5 days after insertion.DESIGN:
A time-sequence nonrandomized intervention study.SETTING:
Adult ICUs (medical, surgical, cardiovascular surgical, neurosurgical, and coronary care) of a tertiary-care university medical center. PATIENTS All patients admitted to the adult ICUs during a 2-year period. The study consisted of a 12-month observational phase (15,960 patient-days) followed by a 12-month intervention phase (15,525 patient-days). INTERVENTION Daily reminders to physicians from the nursing staff to remove unnecessary urinary catheters 5 days after insertion.RESULTS:
The duration of urinary catheterization was significantly reduced during the intervention phase (from 7.0 + 1.1 days to 4.6 +/- 0.7 days; P < .001). The rate of catheter-associated urinary tract infection (CAUTI) was also significantly reduced (from 11.5 +/- 3.1 to 8.3 +/- 2.5 patients with CAUTI per 1,000 catheter-days; P = .009). There was a linear relationship between the monthly average duration of catheterization and the rate of CAUTI (r = 0.50; P = .01). The excess monthly cost of antibiotics for CAUTI was reduced by 69% (from 4021 dollars +/- 1800 dollars to 1220 dollars +/- 941 dollars; P = .004).CONCLUSION:
This study demonstrated that a simple measure instituted as part of a continuous quality improvement program significantly reduced the duration of urinary catheterization, rate of CAUTI, and additional costs of antibiotics to manage CAUTI.
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Base de dados:
MEDLINE
Assunto principal:
Infecções Urinárias
/
Cateterismo Urinário
/
Sistemas de Alerta
/
Cuidados Críticos
/
Remoção de Dispositivo
Tipo de estudo:
Evaluation_studies
/
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
Infect Control Hosp Epidemiol
Assunto da revista:
DOENCAS TRANSMISSIVEIS
/
ENFERMAGEM
/
EPIDEMIOLOGIA
/
HOSPITAIS
Ano de publicação:
2004
Tipo de documento:
Article
País de afiliação:
China