title: Fecal containment in bedridden patients: economic impact of 2 commercial bowel catheter systems.
abstract: BACKGROUND
  Fecal contamination is a major challenge in patients in acute/critical care settings that is associated with increased cost of care and supplies and with development of pressure ulcers, incontinence dermatitis, skin and soft tissue infections, and urinary tract infections.
  
  
  OBJECTIVE
  To assess the economic impact of fecal containment in bedridden patients using 2 different indwelling bowel catheters and to compare infection rates between groups.
  
  
  METHODS
  A multicenter, observational study was done at 12 US sites (7 that use catheter A, 5 that use catheter B). Patients were followed from insertion of an indwelling bowel catheter system until the patient left the acute/critical care unit or until 29 days after enrollment, whichever came first. Demographic data, frequency of bedding/dressing changes, incidence of infection, and Braden scores (risk of pressure ulcers) were recorded.
  
  
  RESULTS
  The study included 146 bedridden patients (76 with catheter A, 70 with catheter B) who had similar Braden scores at enrollment. The rate of bedding/dressing changes per day differed significantly between groups (1.20 for catheter A vs 1.71 for catheter B; P = .004). According to a formula that accounted for personnel resources and laundry cycle costs, catheter A cost $13.94 less per patient per day to use than did catheter B. Catheter A was less likely than was catheter B to be removed during the observational period (P = .03). Observed infection rates were low.
  
  
  CONCLUSIONS
  Catheter A may be more cost-effective than catheter B because it requires fewer unscheduled linen changes per patient day.
authors.affiliation: John H. Stroger Hospital, Cook County, Chicago, Illinois, USA.
authors.forename: Areta
authors.initials: A
authors.lastname: Kowal-Vem
authors.forename: Stathis
authors.initials: S
authors.lastname: Poulakidas
authors.forename: Barbara
authors.initials: B
authors.lastname: Barnett
authors.forename: Deborah
authors.initials: D
authors.lastname: Conway
authors.forename: Daniel
authors.initials: D
authors.lastname: Culver
authors.forename: Michelle
authors.initials: M
authors.lastname: Ferrari
authors.forename: Bruce
authors.initials: B
authors.lastname: Potenza
authors.forename: Michael
authors.initials: M
authors.lastname: Koenig
authors.forename: John
authors.initials: J
authors.lastname: Mah
authors.forename: Mary
authors.initials: M
authors.lastname: Majewski
authors.forename: Linda
authors.initials: L
authors.lastname: Morris
authors.forename: Jan
authors.initials: J
authors.lastname: Powers
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Stokes
authors.forename: Michael
authors.initials: M
authors.lastname: Tan
authors.forename: Sara-Jane
authors.initials: SJ
authors.lastname: Salstrom
authors.forename: Cindy
authors.initials: C
authors.lastname: Zaletel
authors.forename: Shirley
authors.initials: S
authors.lastname: Ambutas
authors.forename: Kathleen
authors.initials: K
authors.lastname: Casey
authors.forename: Jayne
authors.initials: J
authors.lastname: Stein
authors.forename: Mary
authors.initials: M
authors.lastname: DeSane
authors.forename: Kathy
authors.initials: K
authors.lastname: Berry
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Konz
authors.forename: Michael R
authors.initials: MR
authors.lastname: Riemer
authors.forename: Malford E
authors.initials: ME
authors.lastname: Cullum
mesh_terms: D000368:Aged; D002404:Catheterization / Q000191:economics / Q000295:instrumentation*; D003362:Cost-Benefit Analysis; D003422:Critical Care; D003428:Cross Infection / Q000191:economics / Q000517:prevention & control*; D005242:Fecal Incontinence / Q000191:economics / Q000628:therapy*; D006801:Humans; D010865:Pilot Projects; D003668:Pressure Ulcer / Q000517:prevention & control*; D014552:Urinary Tract Infections / Q000517:prevention & control