Successful strategy to decrease indwelling catheter utilization rates in an academic medical intensive care unit
| Autor: | Yizhak Kupfer, Pavan Irukulla, Mangalore Amith Shenoy, Diana Yacoub, Sushilkumar Satish Gupta, Vimbai Nyemba |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Epidemiology Urinary system medicine.medical_treatment Psychological intervention Dermatitis Urinary Catheters 030204 cardiovascular system & hematology Urinary catheterization law.invention 03 medical and health sciences Catheters Indwelling 0302 clinical medicine law Indwelling catheter Humans Medicine 030212 general & internal medicine Risk factor Intensive care medicine Retrospective Studies Cross Infection business.industry Health Policy Public Health Environmental and Occupational Health Quality Improvement Intensive care unit Intensive Care Units Urinary Incontinence Infectious Diseases Medical intensive care unit Catheter-Related Infections Urinary Tract Infections Observational study business |
| Zdroj: | American Journal of Infection Control. 45:1349-1355 |
| ISSN: | 0196-6553 |
| DOI: | 10.1016/j.ajic.2017.06.020 |
| Popis: | Duration of indwelling urinary catheterization is an important risk factor for urinary tract infections. We devised a strategy to decrease the utilization of indwelling urinary catheters (IUCs). We also highlight the challenges of managing critically ill patients without IUCs and demonstrate some of the initiatives that we undertook to overcome these challenges.A retrospective observational outcomes review was performed in an adult medical intensive care unit (ICU) between January 2012 and December 2016. This period included a baseline and series of intervals, whereby different aspects of the strategies were implemented. IUC utilization ratio and catheter-associated urinary tract infection (CAUTI) rates were calculated.Our IUC utilization ratio had a statistically significant decrease from 0.92 (baseline) to 0.28 (after 3 interventions) (P.0001). Similarly, CAUTI rates had a statistically significant decrease from 5.47 (baseline) to 1.08 (after 3 intervention) (P = .0134). These rates sustained a statistically significant difference over the 2-year follow-up period from the last intervention. Incontinence-associated dermatitis (IAD) was identified as a potential complication of not using an IUC. There was no statistically significant change in the IAD rates during 2013-2016.Our interventions demonstrated that aggressive and comprehensive IUC restriction protocol and provider training can lead to a successful decrease in IUC use, leading to a lower IUC utilization ratio and CAUTI rate in a large complex academic ICU setting. |
| Databáze: | OpenAIRE |
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