How and when nurses collect urine cultures on catheterized patients: A survey of 5 hospitals

Jones, Karen; Sibai, Jehad; Battjes, Rebecca; Fakih, Mohamad G.

doi:10.1016/j.ajic.2015.09.003

Cited by 21 publications

(17 citation statements)

References 21 publications

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“…Our literature search revealed two studies that addressed this issue. Jones et al (2016) surveyed 394 RNs from five hospitals regarding appropriate reasons and methods to obtain urine culture specimens on patients with indwelling Foley catheters [ 11 ]. They found that 58% of RNs reported that their colleagues follow recommended collection techniques when collecting urine samples in patients with an indwelling catheter.…”

Section: Discussionmentioning

confidence: 99%

“…Additional studies have investigated non-sterile urine collection techniques and the unnecessary ordering of urine cultures as upstream factors that contribute to the unnecessary treatment of ASB [ 9 , 10 ]. However, there is little known regarding the barriers and facilitators that affect nurse initiated ordering and collection practices in the emergency department (ED) and intensive care unit (ICU) where time constraints may increase the risk of over testing or improper collection techniques [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Reducing unnecessary culturing: a systems approach to evaluating urine culture ordering and collection practices among nurses in two acute care settings

Redwood

Knobloch

Pellegrini

et al. 2018

Antimicrob Resist Infect Control

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BackgroundInappropriate ordering and acquisition of urine cultures leads to unnecessary treatment of asymptomatic bacteriuria (ASB). Treatment of ASB contributes to antimicrobial resistance particularly among hospital-acquired organisms. Our objective was to investigate urine culture ordering and collection practices among nurses to identify key system-level and human factor barriers and facilitators that affect optimal ordering and collection practices.MethodsWe conducted two focus groups, one with ED nurses and the other with ICU nurses. Questions were developed using the Systems Engineering Initiative for Patient Safety (SEIPS) framework. We used iterative categorization (directed content analysis followed by summative content analysis) to code and analyze the data both deductively (using SEIPS domains) and inductively (emerging themes).ResultsFactors affecting optimal urine ordering and collection included barriers at the person, process, and task levels. For ED nurses, barriers included patient factors, physician communication, reflex culture protocols, the electronic health record, urinary symptoms, and ED throughput. For ICU nurses, barriers included physician notification of urinalysis results, personal protective equipment, collection technique, patient body habitus, and Foley catheter issues.ConclusionsWe identified multiple potential process barriers to nurse adherence with evidence-based recommendations for ordering and collecting urine cultures in the ICU and ED. A systems approach to identifying barriers and facilitators can be useful to design interventions for improving urine ordering and collection practices.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Reducing unnecessary culturing: a systems approach to evaluating urine culture ordering and collection practices among nurses in two acute care settings

Redwood

Knobloch

Pellegrini

et al. 2018

Antimicrob Resist Infect Control

View full text Add to dashboard Cite

show abstract

“…There is therefore a necessity to suggest a disinfection of the site before catheterization, an aseptic manipulation of the catheter before its introduction into the urinary tract, and proper maintenance of the whole system of urine compilation. It is important to emphasize that from the moment a catheter is inserted, the risks of bacteriuria and of catheter-associated UTIs increase every day (18).…”

Section: Discussionmentioning

confidence: 99%

Catheter-Associated Urinary Tract Infections at a Hospital in Zinvie, Benin (West Africa)

et al. 2016

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Background: Urinary tract infections are one of the most common nosocomial infections. They are progressively becoming a serious and very recurrent public health problem in Africa. With respect to the limited data available on this situation in Benin, the present study was conducted. Objectives: Its objective was to determine the prevalence of the urinary tract infections among catheterized patients at a hospital in Zinvie (Benin). Patients and Methods:This prospective cross-sectional study was conducted on 60 inpatients from the Services of Emergencies, Medicine and Surgery of the hospital. Urine was collected twice per patient: 10 minutes and 48 hours after the insertion of the catheter. All urine samples were subjected to bacteriological analyses. The sensitivity of bacteria isolates was tested with prescribed antibiotics in the hospital. Hygiene practices during catheterization were recorded by direct observation using a checklist. Results: Two days later, (48 hours after the catheterization), 14 patients out of 60 (23.33%) presented with a urinary infection, of which 1 patient (1.66%) was already infected before the process. Gram-negative bacteria were the most isolated bacteria (79%), with Escherichia coli as the most identified species (63%) followed by Pseudomonas spp. (11%) and Acinetobacter spp. (5%). Gram-positive cocci isolates were essentially Staphylococcus aureus (21%). All bacteria isolates were multidrug resistant. Conclusions: Only a few number of health workers do respect hygiene rules before and after catheterization. Therefore, it is necessary to train health workers involved in such activities on good hygiene practices during catheterization.

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“…Whilst data on catheter specimen of urine (CSU) indication were not collected in the study, it suggests that some urine cultures are being collected routinely on IDC insertion, which has been found in a previous study of nurses' practices (Jones, Sibai, Battjes, & Fakih, 2016).…”

Section: Discussionmentioning

confidence: 95%

Variations in indwelling urinary catheter use in four Australian acute care hospitals

Giles

Graham

Ball

et al. 2019

Journal of Clinical Nursing

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Aims and objectives To identify the point prevalence of indwelling urinary catheters (IDCs) in adult inpatients in acute care hospitals, and to describe the indications for IDC insertion based on patient age, gender, specialty and hospital. Background Catheter‐associated urinary tract infections (CAUTIs) are preventable healthcare‐associated infections. IDC duration is the strongest predictor of CAUTI, and little is known about characteristics of patients who receive an IDC. Design Two single‐day point prevalence surveys collected baseline patient data as part of a larger pre‐post control‐intervention study. Methods Surveys were conducted at four acute care hospitals in NSW, Australia, for all adult patients. Data collection included IDC presence, insertion details and urine culture collection. Point prevalence data were linked with electronically extracted patient demographic data. This study is presented in line with STROBE checklist (See Supplementary File 1). Result Data from 1,630 patients were analysed, with 196 patients (12%) identified as having an IDC on the survey dates. IDC prevalence rates were higher in males (13%) than in females (11%). Critical care had the highest rate of patients with IDCs (42%). Urine cultures were collected in 70 patients with an IDC (43%). Conclusions Findings indicated similar rates of IDC use in males and females, and there was no significant difference in age between patients with or without an IDC. However, indication for IDC varied by patient age and gender. High rates of urine culture collection may represent routine collection. Relevance to clinical practice IDC use is found across genders, all age groups and specialties. Nurses should be aware that any of their patients may have an IDC and be particularly aware of certain indications based on patient age and gender. Routine urine culture collection is not advised, and instead, nurses should be guided by clinical decision‐making tools.

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How and when nurses collect urine cultures on catheterized patients: A survey of 5 hospitals

Cited by 21 publications

References 21 publications

Reducing unnecessary culturing: a systems approach to evaluating urine culture ordering and collection practices among nurses in two acute care settings

Reducing unnecessary culturing: a systems approach to evaluating urine culture ordering and collection practices among nurses in two acute care settings

Catheter-Associated Urinary Tract Infections at a Hospital in Zinvie, Benin (West Africa)

Variations in indwelling urinary catheter use in four Australian acute care hospitals

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