Quality gaps in documenting urinary catheter use and infectious outcomes

Area of Science:

• Urology
• Infectious Diseases
• Healthcare Quality Improvement

Background:

• Urinary catheter use is prevalent in healthcare settings.
• Accurate surveillance of catheter use and associated infections is critical for patient safety.
• Existing methods for tracking catheter-days may be inaccurate.

Purpose of the Study:

• To determine the frequency of all urinary catheter types used.
• To identify positive urine cultures associated with different catheter types.
• To assess the accuracy of catheter-days reporting.

Main Methods:

• Prospective, observational study with patient-level electronic medical record review.
• Involved 7,866 inpatients across internal medicine and long-term care wards.
• Compared chart review data with infection control reporting of catheter-days.

Main Results:

• Urinary catheters were used on 36.9% of observed bed-days.
• External catheters accounted for 48.4% of catheter-days and 37.3% of positive urine cultures.
• Infection control reporting missed 20.1% of indwelling catheter-days and included 12.0% false positives.

Conclusions:

• Urinary catheter utilization is high, with external catheters playing a substantial role in bacteriuria.
• Current practices for tracking urinary catheter-days are unreliable and require improvement.
• Accurate data on catheter use is essential for effective infection prevention strategies.