Effect of Infection Control Program on Catheter Associated Urinary Tract Infection in Intensive Care Units at Zagazig University Hospital

Abstract

Background: Catheter-associated urinary tract infection produces substantial morbidity in hospitalized patients including discomfort, fever, malaise and unnecessary antibiotic use, which may become an important source of antibiotic resistant organisms. Further, the catheterized urinary tract acts as a reservoir for the dissemination of these drug resistant organisms to other patients. Aim of the study: was to improve the safety of intensive care unit (ICU) patients with urinary catheter via decreasing the incidence of catheter-associated urinary tract infection (CAUTI) at Zagazig University Hospital through assessment of knowledge and practice of ICU staff about catheter associated infection and assessment of the incidence of CAUTI among ICU patients in Zagazig University Hospital and implementation of Infection Control Program in the selected ICUs. Subjects and methods: An interventional study (one-group pre-test post-test design) was conducted during the period from 2016 to 2018 at Zagazig university Hospital in two ICUs; surgical and emergency intensive care units. The study was carried out through two phases; the first included the followings: active electronic surveillance for (CAUTI); assessment of health care providers' knowledge about CAUTI before and after intervention through constructed questionnaire and assessment of health care providers' practice before and after intervention by using performance observation checklist. The second phase, included implementation of infection control program based on the conceptual model of Comprehensive Unit-based Safety Program (CUSP). Results: There was a high statistical significant increase in knowledge of resident physicians and nurses about guidelines for prevention of catheter associated urinary tract infection in the studied intensive care units after intervention (P ˂0.01). There was high statistical significant improvement in urinary catheterization practice in the studied intensive care units after intervention (P ˂0.01). Regarding incidence of CAUTI, before intervention, CAUTI incidence was 10.6 per 1000 urinary catheter days. After intervention, CAUTI incidence significantly dropped to 5.4 per 1000 urinary catheter days. Risk of CAUTI before intervention was approximately twice that after intervention. The intervention reduced risk of CAUTI by 49.1%. Regarding isolated pathogens associated with reported CAUTI, the most frequent isolated pathogens were Klebsiella spp. (31.4%), followed by Candida albicans (21.4%), Pseudomonas spp. (14.3%) and E. coli (12.9%) Conclusion: At Zagazig university hospitals' ICUs, implementation of infection control program on CAUTI was noticed to be associated with improvement in healthcare providers' knowledge and practice and decrease in CAUTI incidence. Sustainability is required to maintain such improvement. So. It is recommended to keep continuous training of ICU staff and upgrade ICU protocols according to recent guidelines.

The Effect of Implementing CAUTIs Bundle on Prevention of Hospital- Acquired Urinary Tract Infections among Critically Ill Patients

“…This may be due to the study's inclusion criteria of the age group that ranged from 18 to 45 years old to ensure that the patients were free from infections and other age-related diseases. Similarly, Selim (2018) reported that the mean age of their patients was 37.3 ±11.4 which is congruent with our findings. On the Contrary, Abdel-Hakeim and Hamza (2018) revealed that the most common age group of the studied patients was between 40 and 50 years old with a statistically significant difference between the studied groups.…”

“…This is because the study settings have some limitations such as the lack of some supplies, the high ratio of patients to nurses, and non-compliance of physicians and nurses with handwashing and gloving guidelines during UC insertion or care. In this regard, our findings are supported by several studies which were conducted in developing countries as Egyptian studies (Abdesalam, Ahmed, & Khalil, 2018;Ahmed & Shehata, 2020;Aly, Tawfeek, & Mohamed, 2016;Amine et al, 2014;Ismail et al, 2019;Selim et al, 2018;Talaat et al, 2010), Saudia studies (Abdel-Hakeim, & Hamza, 2018;Raslaan, 2012) and one Lebanese study (Kanj et al, 2013). These studies reported a high CAUTIs rate.…”

“…The current findings showed that the implementation of the CAUTIs bundle resulted in a decrease in the CAUTIs rate among the CAUTIs bundle group (16.5 per 1000) rather than the TC group (30.7 per 1000) with an approximately 50% decrease in CAUTIs rate between both groups. This is supported by the findings of the other two studies which implemented the CAUTIs bundle and reported a 50% reduction in the CAUTIs rates (Davis et al, 2014;Selim et al, 2018).…”

To Assess the Practices of Nurses Towards Catheter Care for Prevention of Catheter Associated Urinary Tract Infection Among Patients Admitted in Tertiary Care Hospital Bathinda (Punjab)

“…The result of the present study revealed that the majority of nurses had adequate level toward CAUTI prevention. This finding is inconsistent with Sobeih and Nasr (2015), who stated that only 12.5% of the studied nurses had competent level of practices as regards urinary catheter care while this result contradicted with Selim et al (2018) 14 and Mukakamanzi (2017), who found that a high percentage of nurses has shown a good implementation of different practices towards catheter CAUTI prevention.…”

The Impact of Web-Enhanced Education on Nursing Students' Learning Skills: A Quasi-Experimental Study

“…This transition has resulted in a greater reliance on OEPs by both faculty and students, both inside and outside the classroom. It serves as a complementary approach to traditional learning methods, providing opportunities for interactive and engaging educational experiences (Schuler et al, 2021). As the nursing field embraces digital advancements, the use of webenhanced learning is expected to play a vital role in facilitating learning and preparing future nurses for their professional roles.…”