TY - JOUR
T1 - Indwelling urinary catheter management and catheter-associated urinary tract infection prevention practices in Nurses Improving Care for Healthsystem Elders hospitals
AU - Fink, Regina
AU - Gilmartin, Heather
AU - Richard, Angela
AU - Capezuti, Elizabeth
AU - Boltz, Marie
AU - Wald, Heidi
N1 - Funding Information:
This work was funded by the Agency for Healthcare Research and Quality (Grant AHRQ R18HSO18377 ). Dr Wald is the recipient of a Paul Beeson Career Development Award in Aging (NIA K23 AG034544) from the National Institute on Aging , the John A. Hartford Foundation , the STARR Foundation , and an anonymous donor .
PY - 2012/10
Y1 - 2012/10
N2 - Background: Indwelling urinary catheters (IUCs) are commonly used in hospitalized patients, especially elders. Catheter-associated urinary tract infections (CAUTIs) account for 34% of all health care associated infections in the United States, associated with excess morbidity and health care costs. Adherence to CAUTI prevention practices has not been well described. Methods: This study used an electronic survey to examine IUC care practices for CAUTI prevention in 3 areas - (1) equipment and alternatives and insertion and maintenance techniques; (2) personnel, policies, training, and education; and (3) documentation, surveillance, and removal reminders - at 75 acute care hospitals in the Nurses Improving the Care of Healthsystem Elders (NICHE) system. Results: CAUTI prevention practices commonly followed included wearing gloves (97%), handwashing (89%), maintaining a sterile barrier (81%), and using a no-touch insertion technique (73%). Silver-coated catheters were used to varying degrees in 59% of the hospitals; 4% reported never using a catheter-securing device. Urethral meatal care was provided daily by 43% of hospitals and more frequently that that by 41% of hospitals. Nurses were the most frequently reported IUC inserters. Training in aseptic technique and CAUTI prevention at the time of initial nursing hire was provided by 64% of hospitals; however, only 47% annually validated competency in IUC insertion. Systems for IUC removal were implemented in 56% of hospitals. IUC documentation and routine CAUTI surveillance practices varied widely. Conclusions: Although many CAUTI prevention practices at NICHE hospitals are in alignment with evidence-based guidelines, there is room for improvement. Further research is needed to identify the effect of enhanced compliance with CAUTI prevention practices on the prevalence of CAUTI in NICHE hospitals.
AB - Background: Indwelling urinary catheters (IUCs) are commonly used in hospitalized patients, especially elders. Catheter-associated urinary tract infections (CAUTIs) account for 34% of all health care associated infections in the United States, associated with excess morbidity and health care costs. Adherence to CAUTI prevention practices has not been well described. Methods: This study used an electronic survey to examine IUC care practices for CAUTI prevention in 3 areas - (1) equipment and alternatives and insertion and maintenance techniques; (2) personnel, policies, training, and education; and (3) documentation, surveillance, and removal reminders - at 75 acute care hospitals in the Nurses Improving the Care of Healthsystem Elders (NICHE) system. Results: CAUTI prevention practices commonly followed included wearing gloves (97%), handwashing (89%), maintaining a sterile barrier (81%), and using a no-touch insertion technique (73%). Silver-coated catheters were used to varying degrees in 59% of the hospitals; 4% reported never using a catheter-securing device. Urethral meatal care was provided daily by 43% of hospitals and more frequently that that by 41% of hospitals. Nurses were the most frequently reported IUC inserters. Training in aseptic technique and CAUTI prevention at the time of initial nursing hire was provided by 64% of hospitals; however, only 47% annually validated competency in IUC insertion. Systems for IUC removal were implemented in 56% of hospitals. IUC documentation and routine CAUTI surveillance practices varied widely. Conclusions: Although many CAUTI prevention practices at NICHE hospitals are in alignment with evidence-based guidelines, there is room for improvement. Further research is needed to identify the effect of enhanced compliance with CAUTI prevention practices on the prevalence of CAUTI in NICHE hospitals.
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U2 - 10.1016/j.ajic.2011.09.017
DO - 10.1016/j.ajic.2011.09.017
M3 - Article
C2 - 22297241
AN - SCOPUS:84863720044
SN - 0196-6553
VL - 40
SP - 715
EP - 720
JO - American journal of infection control
JF - American journal of infection control
IS - 8
ER -