Reduction of Inappropriate Urinary Catheter Use at a Veterans Affairs Hospital Through a Multifaceted Quality Improvement Project

Abstract

Significant hospital-wide reductions in total and inappropriate FC use and improved FC order documentation were achieved through a multicomponent campaign. The greatest and most sustained improvements accompanied the involvement of a dedicated FC nurse.

Do System-Based Interventions Affect Catheter-Associated Urinary Tract Infection?

“…Finally, multifaceted interventions often incorporated audits and feedback. 22 Meddings et al 20 Fuchs et al 23 Elpern et al 24 Fakih et al 7 Apisarnthanarak et al 25 Knoll et al 1 …”

“…Global catheter education, as part of multifaceted interventions, reduced overall prevalence of catheter use, 1,26 and the prevalence of nonordered or nonindicated catheters. 1 Nurses have a pivotal role in collaborating with their physician colleagues to ensure that catheter use is aligned with these guidelines, even in settings like the emergency department. If patients are admitted from outside facilities with catheters, nurses should assess the need for the catheter and communicate with physicians if a physician is not present for prompt removal of the catheter.…”

“…1 An estimated 30 million urinary catheters are used annually in the United States. Prevalence of catheter use among hospitalized patients ranges from 16% to 33% 2,3 and is even higher (67%-76%) in critically ill patients.…”

“…[12][13][14][15] CAUTI is associated with increases in morbidity and mortality, resource utilization, and health care costs. CAUTIs may lead to unnecessary use of antibiotics and antimicrobial resistance and longer hospital stays, 1,10,11,16 with a cumulative additional 90 000 hospital days per year. 17 The cost of a single CAUTI episode varies from $980 to $2900 (depending on presence of bacteremia), 18 with a collective annual US cost of $424 million to $451 million.…”

“…19 Other potential complications of catheterization such as mechanical trauma, urethral strictures, and restricted mobility also affect morbidity, further affecting length of stay and costs. 1,20 The Centers for Disease Control and Prevention estimated that 20% to 70% of all CAUTI events could A regular feature of the American Journal of Critical Care, Clinical Evidence Review unveils available scientific evidence to answer questions faced in contemporary clinical practice. It is intended to support, refute, or shed light on health care practices where little evidence exists.…”