Impact of an evidence-based intervention on urinary catheter utilization, associated process indicators, and infectious and non-infectious outcomes
Multi-centre intervention studies tackling urinary catheterization and its infectious and non-infectious complications are lacking. To decrease urinary catheterization and, consequently, catheter-associated urinary tract infections (CAUTIs) and non-infectious complications. Before/after non-randomiz...
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| Veröffentlicht in: | The Journal of hospital infection 2020-10, Vol.106 (2), p.364-371 |
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| container_title | The Journal of hospital infection |
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| creator | Schweiger, A. Kuster, S.P. Maag, J. Züllig, S. Bertschy, S. Bortolin, E. John, G. Sax, H. Limacher, A. Atkinson, A. Schwappach, D. Marschall, J. |
| description | Multi-centre intervention studies tackling urinary catheterization and its infectious and non-infectious complications are lacking.
To decrease urinary catheterization and, consequently, catheter-associated urinary tract infections (CAUTIs) and non-infectious complications.
Before/after non-randomized multi-centre intervention study in seven hospitals in Switzerland. Intervention bundle consisting of: (1) a concise list of indications for urinary catheterization; (2) daily evaluation of the need for ongoing catheterization; and (3) education on proper insertion and maintenance of urinary catheters. The primary outcome was urinary catheter utilization. Secondary outcomes were CAUTIs, non-infectious complications and process indicators (proportion of indicated catheters and frequency of catheter evaluation).
In total, 25,880 patients were included in this study [13,171 at baseline (August–October 2016) and 12,709 post intervention (August–October 2017)]. Catheter utilization decreased from 23.7% to 21.0% (P=0.001), and catheter-days per 100 patient-days decreased from 17.4 to 13.5 (P=0.167). CAUTIs remained stable at a low level with 0.02 infections per 100 patient-days (baseline) and 0.02 infections (post intervention) (P=0.98). Measuring infections per 1000 catheter-days, the rate was 1.02 (baseline) and 1.33 (post intervention) (P=0.60). Non-infectious complications decreased significantly, from 0.79 to 0.56 events per 100 patient-days (P |
| doi_str_mv | 10.1016/j.jhin.2020.07.002 |
| format | Article |
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To decrease urinary catheterization and, consequently, catheter-associated urinary tract infections (CAUTIs) and non-infectious complications.
Before/after non-randomized multi-centre intervention study in seven hospitals in Switzerland. Intervention bundle consisting of: (1) a concise list of indications for urinary catheterization; (2) daily evaluation of the need for ongoing catheterization; and (3) education on proper insertion and maintenance of urinary catheters. The primary outcome was urinary catheter utilization. Secondary outcomes were CAUTIs, non-infectious complications and process indicators (proportion of indicated catheters and frequency of catheter evaluation).
In total, 25,880 patients were included in this study [13,171 at baseline (August–October 2016) and 12,709 post intervention (August–October 2017)]. Catheter utilization decreased from 23.7% to 21.0% (P=0.001), and catheter-days per 100 patient-days decreased from 17.4 to 13.5 (P=0.167). CAUTIs remained stable at a low level with 0.02 infections per 100 patient-days (baseline) and 0.02 infections (post intervention) (P=0.98). Measuring infections per 1000 catheter-days, the rate was 1.02 (baseline) and 1.33 (post intervention) (P=0.60). Non-infectious complications decreased significantly, from 0.79 to 0.56 events per 100 patient-days (P<0.001), and from 39.4 to 35.4 events per 1000 catheter-days (P=0.23). Indicated catheters increased from 74.5% to 90.0% (P<0.001). Re-evaluations increased from 168 to 624 per 1000 catheter-days (P<0.001).
A straightforward bundle of three evidence-based measures reduced catheter utilization and non-infectious complications, whereas the proportion of indicated urinary catheters and daily evaluations increased. The CAUTI rate remained unchanged, albeit at a very low level.</description><identifier>ISSN: 0195-6701</identifier><identifier>EISSN: 1532-2939</identifier><identifier>DOI: 10.1016/j.jhin.2020.07.002</identifier><language>eng</language><publisher>Elsevier Ltd</publisher><subject>CAUTI ; Haematuria ; Healthcare-associated infection ; Infection control ; Urinary catheter</subject><ispartof>The Journal of hospital infection, 2020-10, Vol.106 (2), p.364-371</ispartof><rights>2020 The Author(s)</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2922-4e22adea741908a6622be69f165f2e84ad0c562b2608977f9dacb69367a6589b3</citedby><cites>FETCH-LOGICAL-c2922-4e22adea741908a6622be69f165f2e84ad0c562b2608977f9dacb69367a6589b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0195670120303303$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids></links><search><creatorcontrib>Schweiger, A.</creatorcontrib><creatorcontrib>Kuster, S.P.</creatorcontrib><creatorcontrib>Maag, J.</creatorcontrib><creatorcontrib>Züllig, S.</creatorcontrib><creatorcontrib>Bertschy, S.</creatorcontrib><creatorcontrib>Bortolin, E.</creatorcontrib><creatorcontrib>John, G.</creatorcontrib><creatorcontrib>Sax, H.</creatorcontrib><creatorcontrib>Limacher, A.</creatorcontrib><creatorcontrib>Atkinson, A.</creatorcontrib><creatorcontrib>Schwappach, D.</creatorcontrib><creatorcontrib>Marschall, J.</creatorcontrib><title>Impact of an evidence-based intervention on urinary catheter utilization, associated process indicators, and infectious and non-infectious outcomes</title><title>The Journal of hospital infection</title><description>Multi-centre intervention studies tackling urinary catheterization and its infectious and non-infectious complications are lacking.
To decrease urinary catheterization and, consequently, catheter-associated urinary tract infections (CAUTIs) and non-infectious complications.
Before/after non-randomized multi-centre intervention study in seven hospitals in Switzerland. Intervention bundle consisting of: (1) a concise list of indications for urinary catheterization; (2) daily evaluation of the need for ongoing catheterization; and (3) education on proper insertion and maintenance of urinary catheters. The primary outcome was urinary catheter utilization. Secondary outcomes were CAUTIs, non-infectious complications and process indicators (proportion of indicated catheters and frequency of catheter evaluation).
In total, 25,880 patients were included in this study [13,171 at baseline (August–October 2016) and 12,709 post intervention (August–October 2017)]. Catheter utilization decreased from 23.7% to 21.0% (P=0.001), and catheter-days per 100 patient-days decreased from 17.4 to 13.5 (P=0.167). CAUTIs remained stable at a low level with 0.02 infections per 100 patient-days (baseline) and 0.02 infections (post intervention) (P=0.98). Measuring infections per 1000 catheter-days, the rate was 1.02 (baseline) and 1.33 (post intervention) (P=0.60). Non-infectious complications decreased significantly, from 0.79 to 0.56 events per 100 patient-days (P<0.001), and from 39.4 to 35.4 events per 1000 catheter-days (P=0.23). Indicated catheters increased from 74.5% to 90.0% (P<0.001). Re-evaluations increased from 168 to 624 per 1000 catheter-days (P<0.001).
A straightforward bundle of three evidence-based measures reduced catheter utilization and non-infectious complications, whereas the proportion of indicated urinary catheters and daily evaluations increased. The CAUTI rate remained unchanged, albeit at a very low level.</description><subject>CAUTI</subject><subject>Haematuria</subject><subject>Healthcare-associated infection</subject><subject>Infection control</subject><subject>Urinary catheter</subject><issn>0195-6701</issn><issn>1532-2939</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9Uc1KJDEQDrKCs-oLeOqjh-22Uj2dnoAXkfUHBC96Dul0NWaYScake2D3NfaFrXb24EkIFKnvh6r6hLiQUEmQ6mpdrd98qBAQKmgrADwSC9nUWKKu9Q-xAKmbUrUgT8TPnNcAwP1mIf49bnfWjUUcChsK2vuegqOys5n6woeR0p7C6GMo-E3JB5v-FM6Ob8RQMY1-4__aGf9V2Jyj83Zk4S5FRzmzQe-ZHFNmOMyGAzlmT_nzG2Iov7TiNLq4pXwmjge7yXT-v56K17vfL7cP5dPz_ePtzVPpUCOWS0K0Pdl2KTWsrFKIHSk9SNUMSKul7cE1CjtUsNJtO-jeuk7pWrVWNSvd1afi8uDL475PlEez9dnRZmMD8TwGl1g3smF7puKB6lLMOdFgdslv-RZGgpkTMGszJ2DmBAy0hhNg0fVBRLzE3lMy2fn5vL1PvLPpo_9O_gG29ZLB</recordid><startdate>202010</startdate><enddate>202010</enddate><creator>Schweiger, A.</creator><creator>Kuster, S.P.</creator><creator>Maag, J.</creator><creator>Züllig, S.</creator><creator>Bertschy, S.</creator><creator>Bortolin, E.</creator><creator>John, G.</creator><creator>Sax, H.</creator><creator>Limacher, A.</creator><creator>Atkinson, A.</creator><creator>Schwappach, D.</creator><creator>Marschall, J.</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202010</creationdate><title>Impact of an evidence-based intervention on urinary catheter utilization, associated process indicators, and infectious and non-infectious outcomes</title><author>Schweiger, A. ; Kuster, S.P. ; Maag, J. ; Züllig, S. ; Bertschy, S. ; Bortolin, E. ; John, G. ; Sax, H. ; Limacher, A. ; Atkinson, A. ; Schwappach, D. ; Marschall, J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2922-4e22adea741908a6622be69f165f2e84ad0c562b2608977f9dacb69367a6589b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>CAUTI</topic><topic>Haematuria</topic><topic>Healthcare-associated infection</topic><topic>Infection control</topic><topic>Urinary catheter</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schweiger, A.</creatorcontrib><creatorcontrib>Kuster, S.P.</creatorcontrib><creatorcontrib>Maag, J.</creatorcontrib><creatorcontrib>Züllig, S.</creatorcontrib><creatorcontrib>Bertschy, S.</creatorcontrib><creatorcontrib>Bortolin, E.</creatorcontrib><creatorcontrib>John, G.</creatorcontrib><creatorcontrib>Sax, H.</creatorcontrib><creatorcontrib>Limacher, A.</creatorcontrib><creatorcontrib>Atkinson, A.</creatorcontrib><creatorcontrib>Schwappach, D.</creatorcontrib><creatorcontrib>Marschall, J.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of hospital infection</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schweiger, A.</au><au>Kuster, S.P.</au><au>Maag, J.</au><au>Züllig, S.</au><au>Bertschy, S.</au><au>Bortolin, E.</au><au>John, G.</au><au>Sax, H.</au><au>Limacher, A.</au><au>Atkinson, A.</au><au>Schwappach, D.</au><au>Marschall, J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of an evidence-based intervention on urinary catheter utilization, associated process indicators, and infectious and non-infectious outcomes</atitle><jtitle>The Journal of hospital infection</jtitle><date>2020-10</date><risdate>2020</risdate><volume>106</volume><issue>2</issue><spage>364</spage><epage>371</epage><pages>364-371</pages><issn>0195-6701</issn><eissn>1532-2939</eissn><abstract>Multi-centre intervention studies tackling urinary catheterization and its infectious and non-infectious complications are lacking.
To decrease urinary catheterization and, consequently, catheter-associated urinary tract infections (CAUTIs) and non-infectious complications.
Before/after non-randomized multi-centre intervention study in seven hospitals in Switzerland. Intervention bundle consisting of: (1) a concise list of indications for urinary catheterization; (2) daily evaluation of the need for ongoing catheterization; and (3) education on proper insertion and maintenance of urinary catheters. The primary outcome was urinary catheter utilization. Secondary outcomes were CAUTIs, non-infectious complications and process indicators (proportion of indicated catheters and frequency of catheter evaluation).
In total, 25,880 patients were included in this study [13,171 at baseline (August–October 2016) and 12,709 post intervention (August–October 2017)]. Catheter utilization decreased from 23.7% to 21.0% (P=0.001), and catheter-days per 100 patient-days decreased from 17.4 to 13.5 (P=0.167). CAUTIs remained stable at a low level with 0.02 infections per 100 patient-days (baseline) and 0.02 infections (post intervention) (P=0.98). Measuring infections per 1000 catheter-days, the rate was 1.02 (baseline) and 1.33 (post intervention) (P=0.60). Non-infectious complications decreased significantly, from 0.79 to 0.56 events per 100 patient-days (P<0.001), and from 39.4 to 35.4 events per 1000 catheter-days (P=0.23). Indicated catheters increased from 74.5% to 90.0% (P<0.001). Re-evaluations increased from 168 to 624 per 1000 catheter-days (P<0.001).
A straightforward bundle of three evidence-based measures reduced catheter utilization and non-infectious complications, whereas the proportion of indicated urinary catheters and daily evaluations increased. The CAUTI rate remained unchanged, albeit at a very low level.</abstract><pub>Elsevier Ltd</pub><doi>10.1016/j.jhin.2020.07.002</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | CAUTI Haematuria Healthcare-associated infection Infection control Urinary catheter |
| title | Impact of an evidence-based intervention on urinary catheter utilization, associated process indicators, and infectious and non-infectious outcomes |
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