title: Assessment of a multi-modal intervention for the prevention of catheter-associated urinary tract infections.
abstract: BACKGROUND
  Catheter-associated urinary tract infections (CAUTIs) represent an important healthcare burden.
  
  
  OBJECTIVE
  To assess the effectiveness of an evidence-based multi-modal, multi-disciplinary intervention intended to improve outcomes by reducing the use of urinary catheters (UCs) and minimizing the incidence of CAUTIs in the internal medicine department of a university hospital.
  
  
  METHODS
  A multi-modal intervention was developed, including training sessions, urinary catheterization reminders, surveillance systems, and mechanisms for staff feedback of results. The frequency of UC use and incidence of CAUTIs were recorded in three-month periods before (P1) and during the intervention (P2).
  
  
  RESULTS
  The catheterization rate decreased significantly during P2 [27.8% vs 16.9%; relative risk (RR): 0.61; 95% confidence interval (CI): 0.57-0.65]. We also observed a reduction in CAUTI risk (18.3 vs 9.8%; RR: 0.53; 95% CI: 0.30-0.93), a reduction in the CAUTI rate per 1000 patient-days [5.5 vs 2.8; incidence ratio (IR): 0.52; 95% CI: 0.28-0.94], and a non-significant decrease in the CAUTI rate per 1000 catheter-days (19.3 vs 16.9; IR: 0.85; 95% CI: 0.46-1.55).
  
  
  CONCLUSIONS
  The multi-modal intervention was effective in reducing the catheterization rate and the frequency of CAUTIs.
authors.affiliation: Internal Medicine Department, University Hospital of Salamanca, Salamanca, Spain; Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain. Electronic address: hgternavasio@saludcastillayleon.es.
authors.forename: H G
authors.initials: HG
authors.lastname: Ternavasio-de la Vega
authors.affiliation: Internal Medicine Department, University Hospital of Salamanca, Salamanca, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Barbosa Ventura
authors.affiliation: Internal Medicine Department, University Hospital of Salamanca, Salamanca, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Castaño-Romero
authors.affiliation: Internal Medicine Department, University Hospital of Salamanca, Salamanca, Spain.
authors.forename: F D
authors.initials: FD
authors.lastname: Sauchelli
authors.affiliation: Internal Medicine Department, University Hospital of Salamanca, Salamanca, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Prolo Acosta
authors.affiliation: Internal Medicine Department, University Hospital of Salamanca, Salamanca, Spain.
authors.forename: F J
authors.initials: FJ
authors.lastname: Rodríguez Alcázar
authors.affiliation: Internal Medicine Department, University Hospital of Salamanca, Salamanca, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Vicente Sánchez
authors.affiliation: Training, Development and Innovation Area, University Hospital of Salamanca, Salamanca, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Ruiz Antúnez
authors.affiliation: Internal Medicine Department, University Hospital of Salamanca, Salamanca, Spain; Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Marcos
authors.affiliation: Internal Medicine Department, University Hospital of Salamanca, Salamanca, Spain; Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Laso
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D055499:Catheter-Related Infections / Q000517:prevention & control*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D017053:Infection Control / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014552:Urinary Tract Infections / Q000517:prevention & control*
keywords: Prevention; Urinary catheter; Urinary tract infection