A reminder reduces urinary catheterization in hospitalized patients.
BACKGROUND
Indwelling urinary catheters are placed in up to 25% of hospitalized patients and are a leading cause of hospital-acquired infection. Duration of catheterization is the dominant risk factor for hospital-acquired urinary tract infection. Physicians are often unaware that their patients have a urinary catheter, and these "forgotten" catheters are frequently unnecessary.


METHODS
A controlled trial, using a pretest-posttest design, was conducted on four hospital wards at an academic medical center. A simple written reminder was designed to aid the hospitalized patient's team in remembering that the patient had a urinary catheter. Two of the four wards were assigned to the intervention group, and two served as controls. A research nurse monitored the urethral catheter status of each patient daily.


RESULTS
A total of 5,678 subjects were evaluated. After adjusting for age, sex, and length of stay, the average proportion of time patients were catheterized increased by 15.1% in the control group but decreased by 7.6% in the intervention group in the intention-to-treat analysis (p = .007). There was no significant difference in urethral recatheterizations between intervention and control groups. The hospital cost savings provided by the intervention offset the necessary costs of this nurse-based intervention. CONCLUSIORN: In the approximately 90% of U.S. hospitals currently without computerized order-entry systems, a written reminder should be considered as one method for improving the safety of hospitalized patients.
Saint
Sanjay
S
Ann Arbor VA Medical Center, USA. saint@med.umich.edu
Kaufman
Samuel R
SR
Thompson
Maureen
M
Rogers
Mary A M
MA
Chenoweth
Carol E
CE
D000046:Academic Medical Centers; D006801:Humans; D007297:Inpatients; D008824:Michigan; D011785:Quality Assurance, Health Care; D017010:Reminder Systems; D014546:Urinary Catheterization / Q000706:statistics & numerical data*; D014552:Urinary Tract Infections / Q000517:prevention & control