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Reduction of unnecessary use of indwelling urinary catheters
  1. Jolien Janzen1,
  2. Bianca M Buurman1,
  3. Lodewijk Spanjaard2,
  4. Theo M de Reijke3,
  5. Astrid Goossens4,
  6. Suzanne E Geerlings1
  1. 1Division Infectious Diseases, Department of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands
  2. 2Department of Medical Microbiology, Academic Medical Center, Amsterdam, The Netherlands
  3. 3Department of Urology, Academic Medical Center, Amsterdam, The Netherlands
  4. 4Department of Quality and Process Innovation, Academic Medical Center, Amsterdam, The Netherlands
  1. Correspondence to Dr Suzanne E Geerlings, Division Infectious Diseases, Department of Internal Medicine, Academic Medical Centre, Room F4-217, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands; s.e.geerlings{at}amc.nl

Abstract

Background The most effective way to reduce catheter-associated urinary tract infections (CA-UTIs) is to avoid unnecessary urinary catheterisation and to minimise the duration of catheterisation.

Aim To implement and assess the effect of an intervention to reduce the duration of urinary tract catheterisation.

Methods This quality improvement project was set up as a before–after comparison consisting of a 2-month pre-intervention period, a period in which the intervention was implemented and a 2-month post-intervention period. The intervention included educational sessions to increase physicians' awareness and the daily reassessment of catheter use. The primary endpoint was the duration of catheterisation. Secondary endpoints were the catheter utilisation ratio, the length of hospital stay, the number of hospital-acquired symptomatic CA-UTIs and the number of appropriate indications for catheterisation.

Results During the total study period, 149 patients (18.3%) were catheterised at some time during their hospital stay. There was a statistically significant decrease in the duration of catheterisation (median 7 vs 5 days; p<0.01), length of hospital stay (median 13 vs 9 days; p<0.01), and number of hospital-acquired CA-UTIs (4 vs 0, p=0.04) in the pre-intervention versus post-intervention period.

Conclusions An intervention to raise more awareness of the risks of inappropriate catheterisation can reduce the duration of catheterisation along with the length of hospital stay and the number of hospital-acquired symptomatic CA- UTIs, even in a short period of time.

  • Healthcare quality improvement
  • Nosocomial infections
  • Reminders

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