title: Effect of education and performance feedback on rates of catheter-associated urinary tract infection in intensive care units in Argentina.
abstract: OBJECTIVE
  To evaluate the effect of education and performance feedback regarding compliance with catheter care and handwashing on rates of catheter-associated urinary tract infection (UTI) in intensive care units (ICUs).
  
  
  METHODS
  Two level III adult ICUs in a private healthcare facility in Argentina.
  
  
  METHODS
  All adult patients admitted to the study units who had a urinary catheter in place for at least 24 hours.
  
  
  METHODS
  A prospective, open trial in which rates of catheter-associated UTI determined during a baseline period of active surveillance without education and performance feedback were compared with rates of catheter-associated UTI after implementing education and performance feedback.
  
  
  RESULTS
  There were 1,779 catheter-days during the baseline period and 5,568 catheter-days during the intervention period. Compliance regarding prevention of compression of the tubing by a leg improved (from 83% to 96%; relative risk [RR], 1.15; 95% confidence interval [CI95], 1.03 to 1.28; P = .01) and so did compliance with handwashing (from 23.1% to 65.2%; RR, 2.82; CI95, 2.49 to 3.20; P < .0001). Catheter-associated UTI rates decreased significantly from 21.3 to 12.39 per 1,000 catheter-days (RR, 0.58; CI%, 0.39 to 0.86; P = .006).
  
  
  CONCLUSIONS
  Implementing education and performance feedback regarding catheter care measures and handwashing compliance was associated with a significant reduction in catheter-associated UTI rates. Similar programs may help reduce catheter-associated UTI rates in other Latin American hospitals.
authors.affiliation: Department of Infectious Diseases and Hospital Epidemiology, Colegiales Medical Center, Buenos Aires, Argentina.
authors.forename: Victor Daniel
authors.initials: VD
authors.lastname: Rosenthal
authors.forename: Sandra
authors.initials: S
authors.lastname: Guzman
authors.forename: Nasia
authors.initials: N
authors.lastname: Safdar
mesh_terms: D000368:Aged; D001118:Argentina / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007318:Inservice Training; D008297:Male; D009741:Nursing Staff, Hospital / Q000193:education*; D011446:Prospective Studies; D014546:Urinary Catheterization / Q000009:adverse effects / Q000451:nursing*; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*