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A program to limit urinary catheter use at an acute care hospital
Alan F Rothfeld1, Avelyne Stickley
1Hollywood Presbyterian Medical Center, Los Angeles, CA, USA. Rothfeld@usc.edu
Insights
Limiting unnecessary urinary catheter use significantly reduced catheter-associated urinary tract infections (CAUTIs). This initiative improved patient safety without negatively impacting nursing satisfaction.
Area of Science:
- Healthcare-associated infections
- Patient safety protocols
- Infection prevention strategies
Background:
- Urinary catheters are a primary source of catheter-associated urinary tract infections (CAUTIs).
- Unnecessary urinary catheterization is common and contributes to CAUTI incidence.
- Reducing catheter use is a key strategy for infection control.
Purpose of the Study:
- To evaluate the impact of a restrictive urinary catheter use policy on CAUTI rates.
- To assess changes in urinary catheter utilization.
- To determine the effect on nursing satisfaction.
Main Methods:
- Implemented a program to limit urinary catheter use to specific clinical indications.
- Recorded urinary catheter use and CAUTI incidence during pre- and post-intervention periods.
- Surveyed nursing staff regarding their experience with the new policy.
Main Results:
- Urinary catheter use decreased by 42% (P < .01).
- Catheter-associated urinary tract infection incidence dropped by 57% (P < .05).
- Nursing satisfaction showed some improvement.
Conclusions:
- A policy limiting urinary catheter use effectively reduces CAUTI rates.
- The reduction in CAUTIs was achieved without compromising nursing satisfaction.
- This approach offers a viable strategy for improving patient safety in healthcare settings.
Background:
Urinary catheters are the major cause of catheter-associated urinary tract infections (CAUTIs) and often may be unnecessary. We attempted to reduce the number of CAUTIs by limiting the use of urinary catheters.
Methods:
The number of catheters and CAUTIs were recorded during a control period of 7 months. A program was implemented limiting these catheters to patients who had urinary tract obstruction, orders for hourly output measurements, breakdown of skin in areas exposed to urine in patients with documented urinary tract infections, or urine- associated skin irritation that was unresponsive to barrier measures. In patients who did not meet these criteria, the physician was asked for a catheter removal order, and superabsorbent pads or diapers were used. Urinary catheter use and CAUTIs were then recorded during a subsequent 5-month intervention period. Nursing personnel were queried regarding their experience after 4 months of the intervention period.
Results:
Urinary catheter use decreased by 42% (P < .01), and the incidence of CAUTIs decreased by 57% (P < .05). There was some improvement in nursing satisfaction.
Conclusion:
Limiting urinary catheter use can reduce the incidence of CAUTI with no deterioration in nursing satisfaction.
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