An intervention to improve the catheter associated urinary tract infection rate in a medical intensive care unit: Direct observation of catheter insertion procedure

Galiczewski, Janet M.; Shurpin, Kathleen

doi:10.1016/j.iccn.2016.12.003

Cited by 35 publications

(24 citation statements)

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“…(2) concentration of specific procedures to certain patient groups; and (3) differences in the clinical management of patients. Further, some studies (Galiczewski and Shurpin, 2017;Kummerow Broman et al, 2018;Fairfield et al, 2018) have reported unsafe treatments, inadequate human and technical resources, and, consequently, poor healthcare practices, leading to variations in the frequency of UTIs among geographic areas. Some hospitals do not observe safety protocols in the insertion, maintenance, and aseptic removal of devices and do not comply with guidelines for the prevention of UTIs, such as the assessment of the need for catheterization (based on individual risk); do not select the type of catheter according to the predicted duration of catheterization; do not implement prevention and control policies for asymptomatic bacteriuria; and do not follow clinical practice guidelines for managing hospitalized patients with diabetes who have UTIs.…”

Section: Discussionmentioning

confidence: 99%

Potentially preventable urinary tract infection in patients with type 2 diabetes – A hospital-based study

Carrondo

Moita

2020

Obesity Medicine

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Aim: To investigate the prevalence of urinary tract infections in hospitalized patients with type 2 diabetes mellitus and identify corresponding risk factors. Methods: We conducted a cross-sectional study on 7.347 patients with type 2 diabetes mellitus as the principal diagnosis, using hospitalization discharge summary data from January 1 to December 31, 2015. Disease stages were classified as stages 1, 2, and 3. Results: Of 7.347 patients, 16.2% had urinary tract infections. The urinary tract infection prevalence was 24.4% in 428 patients in stage 1 and 4.8% in 2.840 patients in stage 2; it was higher among patients who underwent medical procedures than among those who underwent surgery (24.4% vs 4.8%). In multivariate regression analysis, age (OR = 1.031; 95% CI = 1.02-1.04), length of hospitalization (OR = 1.018; 95% CI = 1.013-1.024), sex (woman) (OR = 2.248; 95% CI = 1.778-2.842), comorbidity of stage 3 cerebrovascular disease (OR = 1.737; 95% CI = 1.111-2.714), and comorbidity of stage 1 colorectal cancer (OR = 2.417; 95% CI = 1.152-5.074) were found to be the risk factors of urinary tract infection in the ten hospitals considered. Conclusions: Our findings suggest that urinary tract infection prevalence was higher in women without evidence of organ injury and those receiving medical treatment. Comorbidities (cerebrovascular disease and colorectal cancer) were identified as risk factors.

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Section: Discussionmentioning

confidence: 99%

Potentially preventable urinary tract infection in patients with type 2 diabetes – A hospital-based study

Carrondo

Moita

2020

Obesity Medicine

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“…Assim, sempre que possível, a inserção do CVD deve ser questionada quando as possibilidades de ser substituída por algum destes meios. 1,[8][9][10][13][14][15] Portanto, a conformidade encontrada no Indicador 1 para o setor da Emergência não a exime da necessidade de estabelecimento de ações de controle para ITU-RC, assim como para o setor do CTI que não obteve conformidade neste Indicador.…”

Section: Discussionunclassified

“…O fluxo de urina desobstruído garante que a cada 4 horas haja fluxo de urina intraluminal no cateter vesical garantindo o melhor mecanismo inibitório para o crescimento e migração da maioria das bactérias colonizadoras e de muitos outros patógenos. 1,[8][9][10][13][14][15] Outros estudos que objetivaram identificar os cuidados com o CVD em pacientes de unidades críticas, apontaram não conformidades nos cuidados básicos com o dispositivo e que são contribuintes para a ocorrência de ITU-RC, com destaque à baixa adesão à higienização das mãos e higienização diária da genitália. 5 A equipe de enfermagem representa o maior contingente de profissionais de saúde nas instituições médico-hospitalares, bem como desenvolvem a maioria das atividades do cuidado.…”

Section: Discussionunclassified

“…Além disso, muitos pacientes permanecem com o dispositivo além do tempo necessário, contribuindo para complicações infecciosas, desconforto, restrição da mobilidade e traumas uretrais por tração. [8][9][10][13][14][15] Um estudo realizado em Taiwan, avaliou pacientes geriátricos que fizeram uso de CVD e em 38,3 % dos casos a indicação para o uso do dispositivo era indevida, contribuindo para a permanência desnecessária do…”

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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“…Hospitals and regulatory agencies periodically publish evidence-based guidelines for healthcare personnel to improve practice and reduce infection risks for patients [5,10]. For instance, hospital preventative measures for catheterindwelling patients, such as improved care, hand hygiene and direct observation during the insertion procedure, greatly reduced infection rates [11]. The medical device industry currently relies heavily on the use of antiseptics, antibiotics and other antimicrobial agents [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Surface micropattern reduces colonization and medical device-associated infections

Qiu-hua

Mettetal

et al. 2017

Journal of Medical Microbiology

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* AbstractPurpose. Surface microtopography offers a promising approach for infection control. The goal of this study was to provide evidence that micropatterned surfaces significantly reduce the potential risk of medical device-associated infections.Methodology. Micropatterned and smooth surfaces were challenged in vitro against the colonization and transference of two representative bacterial pathogens -Staphylococcus aureus and Pseudomonas aeruginosa. A percutaneous rat model was used to assess the effectiveness of the micropattern against device-associated S. aureus infections. After the percutaneous insertion of silicone rods into (healthy or immunocompromised) rats, their backs were inoculated with S. aureus. The bacterial burdens were determined in tissues under the rods and in the spleens.Results. The micropatterns reduced adherence by S. aureus (92.3 and 90.5 % reduction for flat and cylindrical surfaces, respectively), while P. aeruginosa colonization was limited by 99.9 % (flat) and 95.5 % (cylindrical). The micropatterned surfaces restricted transference by 95.1 % for S. aureus and 94.9 % for P. aeruginosa, compared to smooth surfaces. Rats with micropatterned devices had substantially fewer S. aureus in subcutaneous tissues (91 %) and spleens (88 %) compared to those with smooth ones. In a follow-up study, immunocompromised rats with micropatterned devices had significantly lower bacterial burdens on devices (99.5 and 99.9 % reduction on external and internal segments, respectively), as well as in subcutaneous tissues (97.8 %) and spleens (90.7 %) compared to those with smooth devices.Conclusion. Micropatterned surfaces exhibited significantly reduced colonization and transference in vitro, as well as lower bacterial burdens in animal models. These results indicate that introducing this micropattern onto surfaces has high potential to reduce medical device-associated infections.

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An intervention to improve the catheter associated urinary tract infection rate in a medical intensive care unit: Direct observation of catheter insertion procedure

Cited by 35 publications

References 35 publications

Potentially preventable urinary tract infection in patients with type 2 diabetes – A hospital-based study

Potentially preventable urinary tract infection in patients with type 2 diabetes – A hospital-based study

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

Surface micropattern reduces colonization and medical device-associated infections

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