A Program to Prevent Catheter-Associated Urinary Tract Infection in Acute Care

Saint, Sanjay; Greene, M. Todd; Krein, Sarah L.; Rogers, Mary A.M.; Ratz, David; Fowler, Karen E.; Edson, Barbara; Watson, Sam R.; Meyer-Lucas, Barbara; Masuga, Marie; Faulkner, Kelly; Gould, Carolyn V.; Battles, James B; Fakih, Mohamad G.

doi:10.1056/nejmoa1504906

Cited by 247 publications

(218 citation statements)

References 22 publications

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“…Pontos específicos de manutenção do CVD como a fixação e fluxo desobstruído, devem ser discutidos entre os enfermeiros e sua equipe de enfermagem para a adequação, conforme protocolos institucionais do cuidado que vem sendo realizado no setor. [16][17][18][19][20][21][22][23] Além do exposto, consideramos essencial a instituição de programas de educação continuada às equipes de saúde que atuam no referido serviço e a educação permanente da equipe multiprofissional a fim de que sejam colocadas em prática as normativas elencadas nos protocolos institucionais, além da formação de uma cultura organizacional que preze pela qualidade do cuidado e na minimização de danos aos pacientes que ali são assistidos. desta insuficiência foi a não conformidade na fixação adequada (70,18%) e no fluxo de urina desobstruído (10,80%).…”

Section: Discussionunclassified

“…[16][17][18][19][20][21][22][23] Salienta-se que, apesar do tempo de permanência não ter sido quantificado em números de dias para análise do Indicador 1, durante as observações diárias constatamos a média de 8,80 dias de permanência do cateter vesical de demora nos setores analisados, valor alto quando comparado ao tempo de instabilidade hemodinâmica (maior justificativa para inserção) nestes pacientes. Segundo estudos, o tempo de permanência é fator crucial para colonização e ITU-RC pelo "crescimento bacteriano iniciar-se após a instalação do cateter, numa proporção de 5-10% ao dia, e estará presente em todos os pacientes ao final de quatro semanas".…”

Section: Discussionunclassified

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Infecção do trato urinário associado ao cateter: Indicadores de Processo para análise das práticas de prevenção em pacientes críticos

Ferreira¹,

Cauduro²

2017

Rev Epidemiol Control Infect

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Exceto onde especificado diferentemente, a matéria publicada neste periódico é licenciada sob forma de uma licença Creative Commons -Atribuição 4. Indicadores, o registro da indicação para o uso do dispositivo (Indicador 1) foi mais satisfatório no setor a Emergência (80,6%) e a fixação adequada (Indicador 2) apresentou não conformidade nos dois setores avaliados (67,5 % no CTI e 96,8 % na Emergência). Conclusão: os Indicadores revelaram não conformidades frente às práticas de prevenção de ITU relacionada ao cateterismo vesical de demora e direcionam a necessidade da implementação de estratégias de orientação das equipes assistenciais e vigilância continua no uso do cateter. Descritores: Indicadores. Indicadores de Qualidade em Assistência à Saúde. Infecçõesurinárias. Cateteres de demora.Background and Objectives: urinary tract infections (UTIs) have a significant impact on patient clinical evolution. Thus, the objective was to analyze, through Process Indicators, the conformities and nonconformities relat-ed to UTI control and prevention practices associated with long-term bladder catheterization in sectors with critically-ill patients. Methods: this was a cross-sectional, observational, documen--tary study with a quantitative approach, performed in an Intensive Care Unit (ICU) and an Emer-gency Unit (EU) of a public hospital in Curitiba. The data collection and analysis were based on Process Indicators created and validated by Fernandez, Lacerda and Hallage (2006). The Indica-tors were evaluated accordingly when their values are between 73 -87% (Indicator 1) and 75 -85% (Indicator 2). Results: for Indicators 1 and 2, the overall conformity rate in the two ana-lyzed sectors was 68.8% and 29.5%, respectively. When the items that subsidized the numera-tors of both Indicators were assessed, the indication record for the device use (Indicator 1) was more satisfactory in the Emergency sector (80.6%) and the appropriate device fixation (Indicator 2) showed nonconformity in the two assessed sectors (67.5% in the ICU and 96.8% in the EU). Conclusion: the Indicators disclosed nonconformities regarding UTI prevention practices related to long-term bladder catheterization and addressed the need for the implementation of strategies to guide the healthcare teams and continued monitoring of catheter use. Keywords

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Section: Discussionunclassified

Infecção do trato urinário associado ao cateter: Indicadores de Processo para análise das práticas de prevenção em pacientes críticos

Ferreira¹,

Cauduro²

2017

Rev Epidemiol Control Infect

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“…Post implementation results were then compared to an extended pre-implementation period with analogous patient populations. CAUTI were reported per 1,000 catheter days consistent with the CDC reporting nomenclature and AHRQ [9].…”

Section: Methodsmentioning

confidence: 99%

“…ICU based units saw an alarming 9% increase in CAUTI in the same 4-year period. Importantly, their protocol did not suggest the implementation of any products that have been suggested to reduce CAUTI rates [9].…”

Section: Introductionmentioning

confidence: 99%

Theraworx Skin Care Formulation Reduces Nosocomial Associated CAUTI Rates When Used for Urinary Catheter Insertion and Maintenance

Renzulli¹

2017

Clin Med Invest

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“…In the set of all HAI, urinary tract infections (UTI) stand out because these are the ones that occur more frequently and are commonly related to the use of a medical device (bladder catheter). [1][2][3][4] Once analysed in a cumulative way, this infection represents significant morbidity for patients and high costs for health systems. 1,[5][6][7][8] Hospital acquired urinary tract infections (HAUTI) are also the most frequent cause of secondary bacteraemia.…”

Section: Introductionmentioning

confidence: 99%

Hospital-Acquired Urinary Tract Infections: Results of a Cohort Study Performed in an Internal Medicine Department

Lobão¹,

Sousa²

2017

Acta Med Port

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33% -48%) of which in the absence of clinical criteria for that procedure. The global cumulative incidence rate for nosocomial urinary tract infections was 4.6% (95% CI: 2.5% -6.7%). Most hospital acquired urinary tract infections (61.1%) were related to bladder catheter use. We quantified 3.06 infections / 1000 patient-days and 14.5 infections / 1000 catheter-days. Catheter associated urinary tract infection occurred at an early stage of hospitalization. The vast majority of patients (66.7%) that developed a catheter associated urinary tract infection were subjected to bladder catheter placement at emergency department. Seventy one per cent of catheter associated urinary tract infection occurred in patients that were subjected to bladder catheter placement without criteria. Discussion: These results point to an excessive and inadequate use of urinary catheters, highlighting the need for judicious use taking into account the formal clinical indications. The incidence of catheter associated urinary tract infection is similar to what we found in other studies. Nevertheless we found a very high incidence density per catheter-days that may foresee a problem probably related to the absence of early withdrawal of the device, and to both bladder catheter placement and maintenance practices. A significant part of catheter associated urinary tract infection occurred in patients that had the bladder catheter placed in the emergency department, before the admission to the internal medicine ward, which highlights the need to assess the urinary catheterization practices in those departments. Conclusion:The high rate of catheter associated urinary tract infection that occurred in the absence of bladder placement indication reinforces the need to implement prevention strategies that contemplate the reduction of its use. Emergency departments should be part of quality improvement projects in this area. Causes for the early onset of catheter associated urinary tract infection in this cohort should be investigated.

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A Program to Prevent Catheter-Associated Urinary Tract Infection in Acute Care

Abstract: A national prevention program appears to reduce catheter use and catheter-associated UTI rates in non-ICUs. (Funded by the Agency for Healthcare Research and Quality.).

Cited by 247 publications

References 22 publications

Infecção do trato urinário associado ao cateter: Indicadores de Processo para análise das práticas de prevenção em pacientes críticos

Infecção do trato urinário associado ao cateter: Indicadores de Processo para análise das práticas de prevenção em pacientes críticos

Theraworx Skin Care Formulation Reduces Nosocomial Associated CAUTI Rates When Used for Urinary Catheter Insertion and Maintenance

Hospital-Acquired Urinary Tract Infections: Results of a Cohort Study Performed in an Internal Medicine Department

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