The effect of a short educational intervention on the use of urinary catheters: a prospective cohort study

Abstract

Objective: To assess the effectiveness of implementation of evidence-based recommendations to reduce catheter-associated urinary tract infections (CAUTIs). Design: Prospective cohort study, conducted in 2010-12, with a before and after design. Setting: A major referral university hospital. Participants: Data were collected before (n = 244) and 1 year after (n = 255) the intervention for patients who received urinary catheters. Intervention: The intervention comprised two elements: (i) aligning doctors' and nurses' knowledge of indications for the use of catheters and (ii) an educational effort consisting of three 30-to 45-minute sessions on evidence-based practice regarding catheter usage for nursing personnel on 17 medical and surgical wards. Main Outcome Measures: The main outcome measures were the proportion of (i) admitted patients receiving urinary catheters during hospitalization, (ii) catheters inserted without indication, (iii) inpatient days with catheter and (iv) the incidence of CAUTIs per 1000 catheter days. Secondary outcome measures were the proportion of (i) catheter days without appropriate indication and (ii) patients discharged with a catheter. Results: There was a reduction in the proportion of inpatient days with a catheter, from 44% to 41% (P = 0.006). There was also a reduction in the proportion of catheter days without appropriate indication (P < 0.001) and patients discharged with a catheter (P = 0.029). The majority of catheters were inserted outside the study wards. Conclusions: A short educational intervention was feasible and resulted in significant practice improvements in catheter usage but no reduction of CAUTIs. Other measures than CAUTI may be more sensitive to detecting important practice changes.

Patient Support Program and Healthcare Resource Utilization in Patients Using Clean Intermittent Catheterization for Bladder Management

“… 2 , 5 , 12 However, evidence concerning the influence of a CIC support program on healthcare utilization is sparse. Blondal and colleagues 13 evaluated an educational effort focused on catheter use for nursing personnel on medical-surgical inpatient care units. They reported a reduction in the proportion of hospital inpatient days with a catheter, from 44% to 41% ( P = .006).…”

“…They reported a reduction in the proportion of hospital inpatient days with a catheter, from 44% to 41% ( P = .006). 13 However, evidence concerning the influence of posthospital CIC-focused education/support programs on healthcare utilization related to CIC is missing.…”

Potential Drug-Drug Interactions in Patients With Urinary Tract Infections: A Contributing Factor in Patient and Medication Safety

“…Urinary tract infections (UTIs) are among the major health problems that affect millions of people (Foxman, 2010; Blondal et al, 2016). Each year, in the United States UTIs account for nearly seven million clinic visits, one million emergency visits, and 100,000 hospital admissions (Schappert, 1999).…”

Unnecessary Complications: The Forgotten Indwelling Urinary Catheter

“…A prospective study revealed that implementation of an education plan to increase physician awareness of inappropriate catheterization resulted in statistically signiicant decreases in IUC duration, CAUTI incidence and hospital length of stay [35]. A 2016 study showed that a brief education program provided to both nursing and physicians regarding proper IUC indications resulted in a signiicant decrease in the proportion of inpatient days with IUC in place [36].…”