title: Reduction of unnecessary use of indwelling urinary catheters.
abstract: BACKGROUND
  The most effective way to reduce catheter-associated urinary tract infections (CA-UTIs) is to avoid unnecessary urinary catheterisation and to minimise the duration of catheterisation.
  
  
  OBJECTIVE
  To implement and assess the effect of an intervention to reduce the duration of urinary tract catheterisation.
  
  
  METHODS
  This quality improvement project was set up as a before-after comparison consisting of a 2-month pre-intervention period, a period in which the intervention was implemented and a 2-month post-intervention period. The intervention included educational sessions to increase physicians' awareness and the daily reassessment of catheter use. The primary endpoint was the duration of catheterisation. Secondary endpoints were the catheter utilisation ratio, the length of hospital stay, the number of hospital-acquired symptomatic CA-UTIs and the number of appropriate indications for catheterisation.
  
  
  RESULTS
  During the total study period, 149 patients (18.3%) were catheterised at some time during their hospital stay. There was a statistically significant decrease in the duration of catheterisation (median 7 vs 5 days; p<0.01), length of hospital stay (median 13 vs 9 days; p<0.01), and number of hospital-acquired CA-UTIs (4 vs 0, p=0.04) in the pre-intervention versus post-intervention period.
  
  
  CONCLUSIONS
  An intervention to raise more awareness of the risks of inappropriate catheterisation can reduce the duration of catheterisation along with the length of hospital stay and the number of hospital-acquired symptomatic CA- UTIs, even in a short period of time.
authors.affiliation: Division Infectious Diseases, Department of Internal Medicine, Academic Medical Center, , Amsterdam, The Netherlands.
authors.forename: Jolien
authors.initials: J
authors.lastname: Janzen
authors.forename: Bianca M
authors.initials: BM
authors.lastname: Buurman
authors.forename: Lodewijk
authors.initials: L
authors.lastname: Spanjaard
authors.forename: Theo M
authors.initials: TM
authors.lastname: de Reijke
authors.forename: Astrid
authors.initials: A
authors.lastname: Goossens
authors.forename: Suzanne E
authors.initials: SE
authors.lastname: Geerlings
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055499:Catheter-Related Infections / Q000517:prevention & control*; D003428:Cross Infection / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D058996:Quality Improvement; D013997:Time Factors; D019564:Unnecessary Procedures / Q000706:statistics & numerical data*; D014546:Urinary Catheterization / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Healthcare quality improvement; Nosocomial infections; Reminders