Fecal containment in bedridden patients: economic impact of 2 commercial bowel catheter systems.
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.
Kowal-Vem
Areta
A
John H. Stroger Hospital, Cook County, Chicago, Illinois, USA.
Poulakidas
Stathis
S
Barnett
Barbara
B
Conway
Deborah
D
Culver
Daniel
D
Ferrari
Michelle
M
Potenza
Bruce
B
Koenig
Michael
M
Mah
John
J
Majewski
Mary
M
Morris
Linda
L
Powers
Jan
J
Stokes
Elizabeth
E
Tan
Michael
M
Salstrom
Sara-Jane
SJ
Zaletel
Cindy
C
Ambutas
Shirley
S
Casey
Kathleen
K
Stein
Jayne
J
DeSane
Mary
M
Berry
Kathy
K
Konz
Elizabeth C
EC
Riemer
Michael R
MR
Cullum
Malford E
ME
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