Reducing catheter-associated urinary tract infections through best practice: Sherwood Forest Hospitals' experience

Palmer, Sally; Dixon, Rosie

doi:10.12968/bjon.2019.28.1.11

Cited by 4 publications

(4 citation statements)

References 2 publications

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“…7,8 Time constraints and working in an intense clinical environment can lead to suboptimal outcomes, though standardizing care to limit variations may improve outcomes. 9 25-bed acute care unit; CLABSI, CAUTI, and C diff infection significantly increased.…”

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confidence: 94%

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Preventing Health Care–Associated Infections Through Implementation of an Interprofessional Visual Management Safety Tracker

Avila

Twibell²,

Demaree³

2022

Journal of Nursing Care Quality

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Background:The management of health care associated infections (HAIs) challenges acute care facilities due to variability in practices. The purpose of this quality improvement project was to decrease central line-associated bloodstream infection, catheter-associated urinary tract infection, and Clostridioides difficile infection in a high acuity care environment using a visual management (VM) tool to address practice variations. Local Problem: An acute care unit experienced increasing HAIs. Methods: An interprofessional team used Lean methodology to implement a VM tool reflective of evidencebased HAI prevention practices that staff had frequently omitted. Interventions: A VM tool called the Safety Tracker was created. Results: In 12 months, HAIs decreased from 9 events to 1, with a corresponding reduction in indwelling urinary catheter utilization and central line utilization. More than $160 000 were avoided in health care costs. Conclusions: Creating an interprofessional VM Safety Tracker could significantly reduce HAIs.

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confidence: 94%

“…These variations can have subtle but cumulative negative effects on patient outcomes 7,8. Time constraints and working in an intense clinical environment can lead to suboptimal outcomes, though standardizing care to limit variations may improve outcomes 9…”

mentioning

confidence: 99%

Preventing Health Care–Associated Infections Through Implementation of an Interprofessional Visual Management Safety Tracker

Avila

Twibell²,

Demaree³

2022

Journal of Nursing Care Quality

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“…To the author’s best knowledge, no previous budget impact analyses have been published on nurse led hospital interventions for reducing catheterisation incidence (Additional file 1 : Literature Review). While studies of similar interventions employing financial costings have been published [ 25 , 26 ], none has produced a detailed impact statement of projected budget costs and savings for decision makers. Economic studies of hospital CAUTI reduction programs, that have attempted to improve and standardise catheterisation practice have shown effectiveness, but usually at a positive economic cost [ 27 ] or with negative incremental costs [ 28 – 30 ].…”

Section: Introductionmentioning

confidence: 99%

Budget impact analysis of a multifaceted nurse-led intervention to reduce indwelling urinary catheter use in New South Wales Hospitals

Ling

Giles

Searles

2022

BMC Health Serv Res

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Background In hospitals, catheter acquired urinary tract infection causes significant resource waste and discomfort among admitted patients. An intervention for reducing indwelling catheterisations - No-CAUTI - was trialled across four hospitals in New South Wales, Australia. No-CAUTI includes: train-the-trainer workshops, site champions, compliance audits, and point prevalence surveys. The trial showed reductions on usual care catheterisation rates at 4- and 9-month post-intervention. This result was statistically non-significant; and post-intervention catheterisation rates rebounded between 4 and 9 months. However, No-CAUTI showed statistically significant catheterisation decreases for medical wards, female patients and for short-term catheterisations. This study presents a budget impact analysis of a projected five year No-CAUTI roll out across New South Wales public hospitals, from the cost perspective of the New South Wales Ministry of Health. Methods Budget forecasts were made for five year roll outs of: i) No-CAUTI; and ii) usual care, among all public hospitals in New South Wales hosting overnight stays (n=180). The roll out design maintains intervention effectiveness with ongoing workshops, quality audits, and hospital surveys. Forecasts of catheterisations, procedures and treatments were modelled on No-CAUTI trial observations. Costs were sourced from trial records, the Medical Benefits Scheme, the Pharmaceutical Benefits Scheme and public wage awards. Cost and parameter uncertainties were considered with sensitivity scenarios. Results The estimated five-year No-CAUTI roll-out cost was $1.5 million. It had an overall budget saving of $640,000 due to reductions of 100,100 catheterisations, 33,300 urine tests and 6,700 antibiotics administrations. Non-Metropolitan hospitals had a net saving of $1.2 million, while Metropolitan hospitals had a net cost of $0.54 million. Conclusions Compared to usual care, NO-CAUTI is expected to realise overall budget savings and decreases in catheterisations over five years. These findings allow a consideration of the affordability of a wide implementation. Trial registration Registered with the Australian New Zealand Clinical Trials Registry (ACTRN12617000090314). First registered 17 January 2017, retrospectively. First enrolment, 15/11/2016.

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“…However, this complication, as an important health problem, threatens the health of patients. Colonized microorganisms in the perineal skin and around the urethra can move into the urinary system through the outer surface of the urinary catheter and cause infection (14). Therefore, interventions designed to prevent the colonization of pathogens around the urinary tract can be very important in controlling CAUTIs (15).…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Effect of Perineal Care with Normal Saline and 2% Chlorhexidine Solution on the Rate of Catheter-Associated Urinary Tract Infection in Women Hospitalized in Intensive Care Units: A Quasi-Experimental Study

et al. 2020

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Background: Urinary tract infection is the most common site of infection associated with health care in the Intensive Care Unit (ICU) patients. Long-term catheterization is the most important risk factor for Urinary Tract Infections (UTIs). These infections are more common in women than in men. Colonized microorganisms in the perineal skin and around the urethra may move into the urinary system through the external surfaces of the urinary catheter to cause infection. Objectives: The present study aimed to compare the effect of perineal care with normal saline and 2% chlorhexidine solution on the rate of catheter-associated urinary tract infection (CAUTI) in women hospitalized in ICUs. Methods: A quasi-experimental study was performed on 70 female patients hospitalized in the ICU of Khatam-Al-Anbia Hospital of Zahedan in 2019. The research units meeting the inclusion criteria were selected using convenience sampling and then randomly divided into two groups of normal saline (n = 35) and chlorhexidine (n = 35). The perineal area of patients in the first group was washed with normal saline and the second group with 2% chlorhexidine solutions twice a day for seven days in both groups. To diagnose UTIs, urine samples were cultured on the first and seventh days. Data were analyzed using SPSS 21 via the independent t-test, chi-square test, and Fisher’s exact test at a significance level of less than 0.05. Results: Finally, 60 participants completed the study. The two groups did not differ significantly in terms of age, marital status, level of education, cause of hospitalization, antibiotic use, underlying diseases, fluid intake, and urinary output. At the end of the seventh day after the intervention, the incidence of UTIs was significantly lower in the chlorhexidine group (13.3%) than in the normal saline group (76.7%) (P = 0.001). Conclusions: The results showed that washing the perineal area every 12 hours with 2% chlorhexidine solution compared to normal saline reduces the incidence of CAUTIs in women hospitalized in ICUs. Therefore, perineal care with a 2% chlorhexidine solution is recommended for perineal care of female patients with urinary catheters hospitalized in ICUs.

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Reducing catheter-associated urinary tract infections through best practice: Sherwood Forest Hospitals' experience

Cited by 4 publications

References 2 publications

Preventing Health Care–Associated Infections Through Implementation of an Interprofessional Visual Management Safety Tracker

Preventing Health Care–Associated Infections Through Implementation of an Interprofessional Visual Management Safety Tracker

Budget impact analysis of a multifaceted nurse-led intervention to reduce indwelling urinary catheter use in New South Wales Hospitals

Comparison of the Effect of Perineal Care with Normal Saline and 2% Chlorhexidine Solution on the Rate of Catheter-Associated Urinary Tract Infection in Women Hospitalized in Intensive Care Units: A Quasi-Experimental Study

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