Controlling urinary tract infections associated with intermittent bladder catheterization in geriatric hospitals

Girard, R.; Gaujard, Sylvain; Pergay, V.; Pornon, P.; Gaujard, G Martin; Vieux, Claude; Bourguignon, Laurent

doi:10.1016/j.jhin.2015.02.008

Cited by 12 publications

(8 citation statements)

References 24 publications

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“…The incidence of 1.7% of patients acquiring a HAUTI is consistent with other literature, but lower than a multicentred French study that reported an incidence of 4.8%. 1,3,23,24 In the USA, a recent multi-site point prevalence study involving 183 hospitals identified the point prevalence of all HCAIs as 4.0%, with 14.4% of these having a HAUTI. 25 An alarming finding from that study was that 23.6% of all patients on the survey day had a urinary catheter in place.…”

Section: Discussionmentioning

confidence: 99%

Length of stay and mortality associated with healthcare-associated urinary tract infections: a multi-state model

Mitchell

Ferguson

Anderson

et al. 2016

Journal of Hospital Infection

108

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This study is the first to explore the burden of HAUTIs in hospitals using appropriate statistical methods in a developed country. Our study indicates that the incidence of HAUTI, in addition to its associated extra length of stay in hospital, presents a burden to the hospital system. With increasing incidence of UTI due to antimicrobial-resistant organisms, surveillance and interventions to reduce the incidence of HAUTI are required.

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Section: Discussionmentioning

confidence: 99%

Length of stay and mortality associated with healthcare-associated urinary tract infections: a multi-state model

Mitchell

Ferguson

Anderson

et al. 2016

Journal of Hospital Infection

108

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“…Eleven studies reported CAUTI rates as the primary outcome [27e32, 34,35,37,41] [25,26,33,36,38,40,42,44,45], and one study reported E. coli in blood or urine [39]. Five studies used an RCT-based design [26,37,40,43,45], 15 studies used a before-and-after design [25,27e36, 39,41,42,44], and one study used a cross-sectional design [38].…”

Section: Resultsmentioning

confidence: 99%

“…Seven of the 15 before-and-after studies met the Critical Appraisal Skills Programme (CASP) cohort guideline criteria [27,32,34e36,41,44]; three did not address all important confounding factors [25,33,39]; four had insufficient follow-up period to determine the long-term effects of the intervention and its implementation [31,37,39,42]; and five did not report significance tests [25,28e30,39].…”

Section: Risk Of Bias In Included Studiesmentioning

confidence: 99%

“…The other two educational studies by Singh et al and Girard et al delivered face-to-face training programmes across hospital staff on geriatric units but neither study found a significant reduction in CAUTI or UTI [32,33]. Singh et al used a faceto-face training intervention in geriatric units at six locations, which covered general infection control, including hand hygiene, sterilization and disinfection, isolation precautions, etc., using didactic sessions, video shows, quizzes, role plays, and tests; despite not finding reductions in CAUTI they did find significant reductions in all other infection rates [32].…”

Section: Education And/or Training Interventionsmentioning

confidence: 99%

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Effectiveness of behavioural interventions to reduce urinary tract infections and Escherichia coli bacteraemia for older adults across all care settings: a systematic review

Jones

Meyrick

Bath

et al. 2019

Journal of Hospital Infection

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Background: Escherichia coli bacteraemia rates in the UK have risen; rates are highest among older adults. Previous urinary tract infections (UTIs) and catheterization are risk factors. Aim: To examine effectiveness of behavioural interventions to reduce E. coli bacteraemia and/or symptomatic UTIs for older adults. Methods: Sixteen databases, grey literature, and reference lists were searched. Titles and/or abstracts were scanned and selected papers were read fully to confirm suitability. Quality was assessed using Critical Appraisal Skills Programme guidelines and Scottish Intercollegiate Guidelines Network grading. Findings: Twenty-one studies were reviewed, and all lacked methodological quality. Six multi-faceted hospital interventions including education, with audit and feedback or reminders reduced UTIs but only three supplied statements of significance. One study reported decreasing catheter-associated UTI (CAUTI) by 88% (F (1,20) ¼ 7.25). Another study reported reductions in CAUTI from 11.17 to 10.53 during Phase I and by 0.39 during Phase II (c 2 ¼ 254). A third study reported fewer UTIs per patient week (risk ratio ¼ 0.39). Two hospital studies of online training and catheter insertion and care simulations decreased CAUTIs from 33 to 14 and from 10.40 to 0. Increasing nursing staff, community continence nurses, and catheter removal reminder stickers reduced infection. There were no studies examining prevention of E. coli bacteraemias. Conclusion: The heterogeneity of studies means that one effective intervention cannot be recommended. We suggest that feedback should be considered because it facilitated reductions in UTI when used alone or in multi-faceted interventions including education, audit or catheter removal protocols. Multi-faceted education is likely to be effective. Catheter removal protocols, increased staffing, and patient education require further evaluation.

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“…Although urinary catheterization plays significant roles in several scenarios, 1,2 it can also cause multiple problems such as urinary tract infections, 3 local symptoms of the urinary tract, 2,4 and delirium. 5,6 In hospitalized elderly patients, urinary catheterization is associated with longer hospital stay and greater risk of mortality.…”

Section: Introductionmentioning

confidence: 99%

Differences among institutions in the prevalence of and indications for urinary catheterization of advanced cancer patients at palliative care units: A multicenter prospective cohort study (EASED)

Higashibata

Hisanaga

Hagiwara³

et al. 2021

Palliat Med

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Background: Studies on the appropriate use of urinary catheters for cancer patients at the end of life are limited. Aim: To clarify the differences among institutions in the prevalence of and indications for urinary catheterization of advanced cancer patients at palliative care units. Design: Pre-planned secondary analysis of a multicenter, prospective cohort study; East-Asian collaborative cross-cultural Study to Elucidate the Dying process (EASED). Setting/participants: This study enrolled consecutive advanced cancer patients admitted to palliative care units between January and December 2017. The final study group comprised 1212 patients from 21 institutions throughout Japan. Results: Out of the 1212 patients, 380 (31.4%; 95% confidence interval, 28.7%–34.0%) underwent urinary catheterization during their palliative care unit stay, and the prevalence of urinary catheterization in patients who died at palliative care units by institution ranged from 0.0% to 55.4%. When the 21 participating institutions were equally divided into three groups according to the institutional prevalence of catheterization, patients with difficulty in moving safely, exhaustion on movement, and restlessness or agitation were more likely to be catheterized in institutions with a high prevalence of catheterization than in those with a low or moderate prevalence ( p < 0.008, p = 0.008, and p < 0.008, respectively). Conclusion: This study revealed that the institutional prevalence of urinary catheterization in advanced cancer patients at palliative care units widely varied. Further studies are needed to establish the appropriate use of urinary catheters, especially in patients with difficulty in moving safely, exhaustion on movement, and restlessness or agitation.

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Controlling urinary tract infections associated with intermittent bladder catheterization in geriatric hospitals

Cited by 12 publications

References 24 publications

Length of stay and mortality associated with healthcare-associated urinary tract infections: a multi-state model

Length of stay and mortality associated with healthcare-associated urinary tract infections: a multi-state model

Effectiveness of behavioural interventions to reduce urinary tract infections and Escherichia coli bacteraemia for older adults across all care settings: a systematic review

Differences among institutions in the prevalence of and indications for urinary catheterization of advanced cancer patients at palliative care units: A multicenter prospective cohort study (EASED)

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