Effect of external urinary collection device implementation on female surgical patients

Lem, Melinda; Jasperse, Nathan; Grigorian, Areg; Kuza, Catherine M.; Deyell, Jacob S; Prasad, J.; Yuan, Charlene; Tomy, Meril; Nahmias, Jeffry

doi:10.1016/j.idh.2022.05.005

Cited by 4 publications

(6 citation statements)

References 14 publications

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Section: Discussionmentioning

confidence: 99%

“…These devices are a newer catheter alternative for female patients (first available in 2016) and can be used for the same clinical indications as condom catheters in male patients. 22 Although data on the benefits and risks of female external catheters are still evolving, [23][24][25] several studies have shown reductions in CAUTI or indwelling catheter use after the introduction of external catheters for female patients. 24,26,27 For CLABSI prevention, the reported regular use of maximum sterile-barrier precautions during catheter insertion and alcoholcontaining chlorhexidine gluconate for insertion-site antisepsis is nearly universal in US hospitals, likely related to the robust evidence for their use 28,29 and their incorporation as part of CLABSI "bundles" used in large-scale collaboratives.…”

Section: Discussionmentioning

confidence: 99%

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What US hospitals are doing to prevent common device-associated infections during the coronavirus disease 2019 (COVID-19) pandemic: Results from a national survey in the United States

Saint

Greene

Krein

et al. 2023

Infect. Control Hosp. Epidemiol.

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Objective: The ways that device-associated infection prevention practices changed during the coronavirus disease 2019 (COVID-19) pandemic remain unknown. We collected data mid-pandemic to assess the use of several infection prevention practices and for comparison with historical data. Design: Repeated cross-sectional survey. Setting: US acute-care hospitals. Participants: Infection preventionists. Methods: We surveyed infection preventionists from a national random sample of 881 US acute-care hospitals in 2021 to estimate the current use of practices to prevent catheter-associated urinary tract infection (CAUTI), central line–associated bloodstream infection (CLABSI), and ventilator-associated events (VAE). We compared the 2021 results with those from surveys occurring every 4 years since 2005. Results: The 2021 survey response rate was 47%; previous survey response rates ranged from 59% to 72%. Regular use of most practices to prevent CLABSI (chlorhexidine gluconate for site antisepsis, 99.0%, and maximum sterile barrier precautions, 98.7%) and VAE (semirecumbent positioning, 93.4%, and sedation vacation, 85.8%) continued to increase or plateaued in 2021. Conversely, use of several CAUTI prevention practices (portable bladder ultrasound scanner, 65.6%; catheter reminders or nurse-initiated discontinuation, 66.3%; and intermittent catheterization, 37.3%) was lower in 2021, with a significant decrease for some practices compared to 2017 (P ≤ .02 for all comparisons). In 2021, 42.1% of hospitals reported regular use of the newer external urinary collection devices for women. Conclusions: Although regular use of CLABSI and VAE preventive practices continued to increase (or plateaued), use of several CAUTI preventive practices decreased during the COVID-19 pandemic. Structural issues relating to care during the pandemic may have contributed to a decrease in device-associated infection prevention practices.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

What US hospitals are doing to prevent common device-associated infections during the coronavirus disease 2019 (COVID-19) pandemic: Results from a national survey in the United States

Saint

Greene

Krein

et al. 2023

Infect. Control Hosp. Epidemiol.

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“…Skin Complications 8 20,23,25,30,34,38,42,65 3 studies reported erythema and skin breakdown due to device firmness, high suction, or allergic reaction to device material. 1 study found that hospital-associated pressure injuries (HAPIs) nonsignificantly increased after FEUWD implementation.…”

Section: More Data Neededmentioning

confidence: 99%

“…Mobility-Related Complications 2 23,25 Cases of deep vein thrombosis and pulmonary embolism were reported following FEUWD implementation. *…”

Section: Feuwds Slightly Favoredmentioning

confidence: 99%

“…Studies with serious ROBs demonstrated additional methodological problems. For example, both studies with serious ROBs, which shared language to describe the absence of an implementation protocol, failed to account for temporal changes to intervention status, making it difficult to ascertain which device type (FEUWD or IUC) had the effect of increasing their indwelling CAUTI and FEUWD-associated UTI rates 23,25 .…”

Section: Limitationsmentioning

confidence: 99%

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Clinical outcomes of female external urine wicking devices as alternatives to indwelling catheters: a systematic review and meta-analysis

Pryor,

Wang,

Young

et al. 2024

Infect. Control Hosp. Epidemiol.

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Background: Female patients using indwelling urinary catheters (IUCs) are disproportionately at risk for developing catheter-associated urinary tract infections (CAUTIs) compared to males. Female external urine wicking devices (FEUWDs) have emerged as potential alternatives to IUCs for incontinence management. Objectives: To assess the clinical risks and benefits of FEUWDs as alternatives to IUCs. Methods: Ovid MEDLINE, Embase, Scopus, Web of Science Core Collection, CINAHL Complete, and ClinicalTrials.gov were searched from inception to July 10, 2023. Included studies used FEUWDs as an intervention and reported measures of urinary tract infections and secondary outcomes related to incontinence management. Results: Of 2,580 returned records, 50 were systematically reviewed. Meta-analyses assessed rates of indwelling CAUTIs and IUC utilization. Following FEUWD implementation, IUC utilization rates decreased 14% (RR = 0.86, 95% CI = [0.76, 0.97]) and indwelling CAUTI rates nonsignificantly decreased up to 32% (IRR = 0.68, 95% CI = [0.39, 1.17]). Limited only to studies that described protocols for implementation, the incidence rate of indwelling CAUTIs decreased significantly up to 54% (IRR = 0.46, 95% CI = [0.32, 0.66]). Secondary outcomes were reported less routinely. Conclusions: Overall, FEUWDs nonsignificantly reduced indwelling CAUTI rates, though reductions were significant among studies describing FEUWD implementation protocols. We recommend developing standard definitions for consistent reporting of non-indwelling CAUTI complications such as FEUWD-associated UTIs, skin injuries, and mobility-related complications.

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Health Care-Associated Infections in Older Adults

Tesini

Dumyati

2023

Infectious Disease Clinics of North America

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Effect of external urinary collection device implementation on female surgical patients

Cited by 4 publications

References 14 publications

What US hospitals are doing to prevent common device-associated infections during the coronavirus disease 2019 (COVID-19) pandemic: Results from a national survey in the United States

What US hospitals are doing to prevent common device-associated infections during the coronavirus disease 2019 (COVID-19) pandemic: Results from a national survey in the United States

Clinical outcomes of female external urine wicking devices as alternatives to indwelling catheters: a systematic review and meta-analysis

Health Care-Associated Infections in Older Adults

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