Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2019 Feb;98(8):e14417.
doi: 10.1097/MD.0000000000014417.

Long-term prevention of catheter-associated urinary tract infections among critically ill patients through the implementation of an educational program and a daily checklist for maintenance of indwelling urinary catheters: A quasi-experimental study

Mayra Gonçalves Menegueti  1 , Marcia A Ciol  2 , Fernando Bellissimo-Rodrigues  3 , Maria Auxiliadora-Martins  4 , Gilberto Gambero Gaspar  5 , Silvia Rita Marin da Silva Canini  1 , Anibal Basile-Filho  4 , Ana Maria Laus  1
Affiliations
Clinical Trial

Long-term prevention of catheter-associated urinary tract infections among critically ill patients through the implementation of an educational program and a daily checklist for maintenance of indwelling urinary catheters: A quasi-experimental study

Mayra Gonçalves Menegueti et al. Medicine (Baltimore). 2019 Feb.

Abstract

Background: Removing an indwelling urinary catheter as soon as possible is the cornerstone of catheter-associated urinary tract infections (CAUTI) prevention. However, implementing this measure may be challenging in clinical settings. To evaluate the impact of implementing a healthcare workers (HCWs) educational program and a daily checklist for indwelling urinary catheter indications among critical patients on the incidence of CAUTI.

Methods: This was a quasi-experimental study performed in a general intensive care unit of a tertiary-care hospital over a 12 years period, from January 1, 2005 to December 31, 2016. Rates of urinary catheter use and incidence density of CAUTI were monthly evaluated following the Centers for Disease Control and Prevention (CDC) criteria throughout the study period. Phase I (2005-2006) was the pre-intervention period. In phase II (2007-2010), HCWs routine training on CAUTI prevention was performed twice-a-year. In phase III (2011-2014), we implemented a daily checklist for indwelling urinary catheter indications, in addition to the biannual training. In phase IV, (2015-2016) the biannual training was replaced by training only newly hired HCWs and the daily checklist was maintained.

Results: The mean rate of urinary catheter utilization decreased from phase I to phase IV (73.1%, 74.1%, 54.9%, and 45.6%, respectively). Similarly, the incidence density of CAUTI decreased from phase I to phase IV (14.9, 7.3, 3.8, and 1.1 per 1000 catheter-days, respectively).

Conclusions: HCWs education and daily evaluation of indwelling urinary catheter indications were highly effective in reducing the rates of catheter utilization as well as the incidence density of CAUTI.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interest.

None of the authors have any conflict of interest to disclose.

Figures

Figure 1
Figure 1
Percent of catheter utilization per month for all phases of the study.
Figure 2
Figure 2
Catheter-associated urinary tract infections incidence monthly rates for all phases of the study.
See this image and copyright information in PMC

References

    1. Pittet D. Infection control and quality health care in the new millennium. Am J Infect Control 2005;33:258–67. - PubMed
    1. Saint S, Chenowith CE. Biofilms and catheter-associated urinary tract infections. Infect Dis Clin North Am 2003;17:411–32. - PubMed
    1. Ha US, Cho YH. Catheter-associated urinary tract infections: new aspects of novel urinary catheters. Int J Antimicrob Agents 2006;28:485–90. - PubMed
    1. Gould CV, Umscheid CA, Agarwal RK, Kuntz G, Pegues DA. Healthcare Infection Control Practices Advisory Committee. Guideline for Prevention of Catheter-Associated Urinary Tract Infections; 2009. Available at: http://www.cdc.gov/hicpac/cauti/001_cauti.html Accessed July 16, 2015. - PubMed
    1. Klevens RM, Edwards JR, Richards CL, Jr, et al. Estimating health care-associated infections and deaths in U.S. hospitals, 2001. Public Health Rep 2007;122:160–6. - PMC - PubMed

Publication types

MeSH terms