title: Using a criteria-based reminder to reduce use of indwelling urinary catheters and decrease urinary tract infections.
abstract: BACKGROUND
  Duration of indwelling urinary catheterization is an important risk factor for urinary tract infection.
  
  
  OBJECTIVE
  To determine whether a reminder approach reduces the use of urinary catheters and the incidence of catheter-associated urinary tract infections.
  
  
  METHODS
  A randomized control trial was performed in 2 respiratory intensive care units in a 2990-bed tertiary referral medical center. Patients who had urinary catheters in place for more than 2 days from April through November 2008 were randomly assigned to either the intervention group (use of a criteria-based reminder to remove the catheter) or the control group (no reminder).
  
  
  RESULTS
  A total of 278 patients were recruited. Utilization rate of indwelling urinary catheters was decreased by 22% in the intervention group compared with the control group (relative risk, 0.78; 95% CI, 0.76-0.80; P < .001). The intervention significantly shortened the median duration of catheterization (7 days vs 11 days for the control group; P < .001). The success rate for removing the catheters in the intervention group by day 7 was 88%. The reminder intervention reduced the incidence of catheter-associated infections by 48% (relative risk, 0.52; 95% CI, 0.32-0.86; P = .009) in the intervention group compared with the control group.
  
  
  CONCLUSIONS
  Use of a criteria-based reminder to remove indwelling urinary catheters can diminish the use of urinary catheterization and reduce the likelihood of catheter-associated urinary infections. This reminder approach can prevent catheter-associated urinary infections, and its use should be strongly considered as a way to enhance the safety of patients.
authors: Department of Infection Control and Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Yin-Yin
authors: YY
authors: Chen
authors: Mei-Man
authors: MM
authors: Chi
authors: Yu-Chih
authors: YC
authors: Chen
authors: Yu-Jiun
authors: YJ
authors: Chan
authors: Shin-Shang
authors: SS
authors: Chou
authors: Fu-Der
authors: FD
authors: Wang
mesh_terms: D000368:Aged; D055499:Catheter-Related Infections / Q000209:etiology / Q000517:prevention & control*; D002408:Catheters, Indwelling / Q000009:adverse effects* / Q000592:standards; D003428:Cross Infection / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D017010:Reminder Systems; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000150:complications / Q000628:therapy; D013624:Taiwan; D062606:Tertiary Care Centers; D013997:Time Factors; D014546:Urinary Catheterization / Q000009:adverse effects* / Q000592:standards; D014552:Urinary Tract Infections / Q000209:etiology / Q000517:prevention & control*