Reducing Foley Catheter Device Days in an Intensive Care Unit

Abstract

The prolonged use of indwelling urinary catheters can lead to many complications, the most prevalent being urinary tract infections. These hospital-acquired infections can increase hospital costs, length of stay, and mortality rates. Evidence-based guidelines for the prevention of urinary tract infections are compared and discussed. Minimizing indwelling urinary catheter use is well-recognized in the literature to reduce the risk of these infections. To decrease the incidence of catheter-associated urinary tract infections, the staff of a 22-bed, mixed medical, surgical, and trauma intensive care unit focused on reducing the number of foley catheter device days. A multidisciplinary team was convened to create an evidence-based plan. Staff nurses were engaged in the development and implementation of the plan. Criteria-based foley catheter guidelines, a decision-making algorithm, and a daily checklist were implemented that led to a significant reduction in foley catheter device days and a decrease in catheter-associated urinary tract infections.

Using A Criteria-Based Reminder To Reduce Use Of Indwelling Urinary Catheters And Decrease Urinary Tract Infections

“…Two other of characteristics of the indwelling urinary catheters between the control and intervention group in the intention-to-treat analysis UTIs was reduced significantly (6.8%-7.5%; P < .05). In another investigation, Reilly et al 24 used criteriabased guidelines, a decision-making algorithm, and a daily checklist and found a significant reduction in the time indwelling urinary catheters were in place and a decrease in CAUTIs. In their systematic review, Meddings et al 14 pointed out that using a reminder intervention method significantly reduced the rate of CAUTIs by 56%.…”

Reducing the Incidence of Catheter-Associated Urinary Tract Infections Through the Adoption of an Evidence-Based Protocol in the Cardiac Care Unit

“…4 In anticipation of this change, the cardiac care unit (CCU) at PENN Presbyterian Medical Center aimed to decrease the incidence of CAUTI by instituting evidence-based practice guidelines and criteria for catheter insertion and management. In January 2006, the CCU instituted the Institute for Healthcare Improvement's bundle practices for prevention of central line-associated bloodstream infections and ventilator-acquired pneumonia.…”

“…In other studies, reminders were placed in the chart, but currently less than 10% of hospitals use catheter reminders despite evidence of benefit and high face validity. 4,5 In February 2008, as a result of the success at PENN Presbyterian, the criteria was added to a drop-down box in the order set in the computerized order-entry system for a Foley catheter in all 3 entities in the University of Pennsylvania Health System.…”

Teaching Evidence-Based Practice in the Hospital and the Library: Two Different Groups, One Course

“…The course packet contained information to complement each section: articles demonstrating the use of models, best practices for journal clubs, sample critical appraisal worksheets, and more. 4,[7][8][9][10][11][12] In the interest of time, only one major model, the Iowa Model for Evidence-based Nursing Practice, was covered in depth. (This was also the model that nursing staff had selected for use in the hospital.)…”