Active training and surveillance: 2 good friends to reduce urinary catheterization rate

Abstract

Background: Because catheter-associated urinary tract infections (CAUTI) represent the most frequent health care-associated infection (HAI), we implemented an educational intervention on urinary catheter use to reduce the CAUTI rate.

Methods: The intervention was focused on correct management of catheterized patients. To assess the participants' knowledge, pre- and post-tests were performed. An active CAUTI surveillance program took place in a 900-bed teaching hospital in central Italy before and after the educational intervention. CAUTI definition, catheterization rate, and CAUTI rate were expressed according to the Centers for Disease and Prevention/National Healthcare Safety Network definitions. The level of significance was set at P ≤ .05.

Results: Two hundred ninety-six health care workers attended the educational intervention; the analysis of the pre- and post-tests highlighted a statistically significant improvement (P < .05). Before the intervention, mean catheterization rate was 18.5% (95% confidence interval [CI]:18.1-18.9); 46 cases of CAUTI were detected, with an incidence rate of 6.6/1,000 catheter-days (95% CI: 4.8-8.8). After the intervention, mean catheterization rate was 9.2% (95% CI: 8.9-9.5); 19 cases of CAUTI were detected, with an incidence rate of 5.8/1,000 catheter-days (95% CI: 3.5-9.0).

Conclusion: Through an active educational update and thanks to the implementation of a surveillance system, a successful reduction of catheterization rate was achieved. More efforts are needed to preserve this goal and to improve the CAUTI rate also.