Summary of CAUTI and urinary catheter (UC) outcomes reported for studies with reminder or stop-order interventions, evaluated as potential studies to include in meta-analyses
| CAUTI outcomes | Indwelling urinary catheter use outcomes | |||||
|---|---|---|---|---|---|---|
| 1st author (year) | Interventions* | CAUTI per 1000 catheter days | % Patients who developed CAUTI | Mean days of UC use per patient | % Patient days with UC in use | % Patients with UC used |
| Adams (2010)60 | S | 25 → 7.6 | ||||
| Andreessen (2012)28 | P, S, B | 5.6 → 2.9† | All catheterised‡ | |||
| Apisarnthanarak (2007)47 | R | 21.5 → 5.2† | 11.0 → 3.0† | 82 → 84 | ||
| Bruminhent (2010)53 | R | 7.02 → 2.08†§ | All catheterised‡ | |||
| Cornia (2003)26 | P, S, E | 8.8 → 13.8 | 8.0 → 5.0† | All catheterised‡ | ||
| Crouzet (2007)48 | R | 12.3 → 1.8† | 10.6 → 1.1† | 8.4 → 6.7 | All catheterised‡ | |
| Dumigan (1998)33 | P, S, E | 14.3 → 9.2 | 74 → 76 | |||
| Elpern (2009)34 | P, R | 4.7 → 0† | All catheterised‡ | |||
| Fakih (2008)50 | R | 20 → 16† | ||||
| Fuchs (2011)35 | P, S | 2.88 → 1.46 | All catheterised‡ | |||
| Gotelli (2008)56 | S | 24.0 → 17.0 | ||||
| Huang (2004)49 | R | 11.5 → 8.3† | 3.8 → 2.4† | 7.0 → 4.6† | 74.5 → 76.2 | |
| Jain (2006)44 | R, B, A | 3.8 → 2.4 | ||||
| Knoll (2011)24 | P, R, S, B, O | Mean daily UC prevalence: 15.2 → 13.7§ | ||||
| Loeb (2008)57 | S | 2.1 → 2.1 | 5.0 → 3.7† | All catheterised‡ | ||
| Murphy (2007)54 | R, E | Reduced UTI rates by 30%, no details | ||||
| Reilly (2008)36 | P, R, E | 4.7 → 3.0 | 96 → 86 | All catheterised‡ | ||
| Robinson (2007)55 | S | 40.0 → 13.3 | 8.6 → 4.5 | |||
| Roser (2012)61 | P, S, O | CAUTI (details unclear): 45 → 28 | UC ‘Utilisation rates’: ICU: 84 → 68 (not further defined) MedSurg: 16 → 11 | |||
| Rothfield (2010)30 | P, S | 3.2 → 2.4 | 33.3 → 18.5† | 33.3 → 18.8 | ||
| Saint (2005)52 | R | 0.6 → 0.4† | 14 → 13 | |||
| Schultz (2011)37 | P, S | 90–95 → 76–84 | ||||
| Sequin (2010)51 | S | 5.0 → 4.9 | 4.3 → 3.0 | Median 5.0 → 4.0† | 92.7 → 91.2 | |
| Stephan (2006)32 | P, S, E | 45.8 → 18.6† | 5.0 → 3.9† | |||
| Titsworth (2012)46 | P, R, S, B, A, O | 13.3 → 4.0† | UC Utilisation rates of ICU beds with UCs:100 → 73 | |||
| Topal (2005)31 | P, S, E | 36.0 → 19.0† | 19.5 → 12.3 | 16 → 10† | ||
| Van den Broek (2011)38 | P, R, S, O | 12.6 → 12.7 | ICU/CCU: 25.6 → 16.2 Med: 14.9 → 12.5† Neuro: 15.8 → 15.7 Surg: 11.8 → 10.5† | ICU/CCU: 74 → 81 Med: 14 → 14 Neuro: 20 → 19 Surg: 21 → 19† | ||
| Voss (2009)58 | S | 4.9 → 3.9 | 26 → 10 | 33 → 15.3 | ||
| Weitzel (2008)45 | R | 37 → 6.7 | 8.6 → 4.5 | |||
| Wenger (2010)59 | S, E, A | 2.26 → 1.02† | ||||
A grey-shaded table cell indicates that the outcome was not reported in the study.
*Intervention key (note: interventions described in more detail in online supplementary appendix table).
†Difference of p<0.05 reported between comparison group (before intervention or control) → postintervention group.
‡Not applicable, as only catheterised patients were included for these studies (so 100% catheterised).
§Reporting first published postintervention result, for this study that reported serial postintervention results.
P=Intervention to avoid unnecessary catheter Placement (eg, restricted indications of use, bladder scanner protocols, etc).
R=Reminder intervention that UC is still present, could be directed at either physician or nurse.
S=Stop order intervention, prompting/requiring removal of the UC based on time or clinical criteria.
E=Education regarding UC placement or maintenance.
B=Bladder bundle of interventions (which included UC placement, maintenance care standardisation).
A=Antimicrobial UCs.
O=Other CAUTI or catheter-related interventions, detailed in online supplementary appendix table.
CAUTI, catheter-associated urinary tract infection; CCU, coronary care units; ICU, intensive care units; UTI, urinary tract infection.