[Using an Indicator-Based Reminder of Catheter Removal to Effectively Decrease Catheter-Associated Urinary Tract Infections in General Medical Patients].
BACKGROUND
Urinary tract infections are a common iatrogenic infection in healthcare institutions. Catheter-associated urinary tract infections (CAUTIs) may result in sepsis, prolonged hospitalization, additional hospital costs, and mortality.


OBJECTIVE
The study examined the efficacy of an indicator-based reminder of catheter removal in decreasing CAUTIs among patients in the general medical ward.


METHODS
A two-group, quasi-experimental design was used. The intervention strategies included daily implementation of the indicator-based reminder procedure and standardized Foley care and a teaching program for all staff nurses. All patients who received Foley during hospitalization were included, with the exception of those with CAUTI at admission. Seventy-five patients were enrolled from five wards in a medical center, with 33 assigned to the control group and 42 assigned to the experimental group.


RESULTS
CAUTIs were diagnosed in 7 participants (16.7%) in the experimental group and 15 participants (45.5%) in the control group. The differences were statistically significant (p = .014). The mean number of Foley days was 14.73% less in the experimental group, with 11.0 for the experimental group and 12.9 for the control group. The incidence density of CAUTIs was 15.2% for the experimental group and 35.3% for the control group.


CONCLUSIONS
The present study supports that an indicator-based reminder of catheter removal decreases the incidence rate and incidence density of CAUTIs. Medical personnel in the general medical ward may use this reminder to detect unnecessary indwelling of urinary catheters and to remove Foley catheters as early as feasible in order to prevent CAUTIs.
Department of Nursing, Taipei Veterans General Hospital, Taiwan, ROC.
Pey-Tsung
PT
Wang
Department of Nursing, Taipei Veterans General Hospital, Taiwan, ROC.
Hsiang-Yu
HY
Lin
Department of Nursing, Taipei Veterans General Hospital, Taiwan, ROC.
Yi-Tsun
YT
Lin
Department of Nursing, Taipei Veterans General Hospital, Taiwan, ROC.
Wen-Huey
WH
Shin
Institute of Community Health Care, National Yang-Ming University, Taiwan, ROC.
Li-Yin
LY
Chien
Department of Nursing, Taipei Veterans General Hospital, Taiwan, ROC. sllin@vghtpe.gov.tw.
Shirling
S
Lin
D000368:Aged; D000369:Aged, 80 and over; D055499:Catheter-Related Infections / Q000517:prevention & control*; D020878:Device Removal / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017010:Reminder Systems; D014546:Urinary Catheterization / Q000009:adverse effects*; D014552:Urinary Tract Infections / Q000517:prevention & control*
catheter-associated urinary tract infections; general medical patients; indicators-based reminder of catheter removal