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Published on: June 24, 2025
[Using an Indicator-Based Reminder of Catheter Removal to Effectively Decrease Catheter-Associated Urinary Tract
Pey-Tsung Wang1, Hsiang-Yu Lin1, Yi-Tsun Lin1
1Department of Nursing, Taipei Veterans General Hospital, Taiwan, ROC.
Insights
An indicator-based reminder significantly reduced catheter-associated urinary tract infections (CAUTIs) in a general medical ward. This intervention helps prevent CAUTIs by prompting timely urinary catheter removal.
Area of Science:
- Healthcare-associated infections
- Infection control
- Patient safety
Background:
- Urinary tract infections (UTIs) are common iatrogenic infections in healthcare settings.
- Catheter-associated urinary tract infections (CAUTIs) can lead to severe complications like sepsis, prolonged hospitalization, increased costs, and mortality.
Purpose of the Study:
- To evaluate the effectiveness of an indicator-based reminder system for urinary catheter removal in reducing CAUTIs.
- To assess the impact of this intervention on patients in a general medical ward.
Main Methods:
- A quasi-experimental design with two groups (control and experimental) was employed.
- The intervention included daily reminders for catheter removal, standardized Foley care, and staff nurse education.
- Seventy-five patients were enrolled across five medical center wards.
Main Results:
- CAUTIs occurred in 16.7% of the experimental group versus 45.5% in the control group (p = .014).
- The experimental group had 14.73% fewer Foley catheter days (11.0 vs. 12.9 days).
- CAUTI incidence density was significantly lower in the experimental group (15.2%) compared to the control group (35.3%).
Conclusions:
- An indicator-based reminder effectively decreases the incidence rate and density of CAUTIs.
- This reminder system aids healthcare professionals in identifying and removing unnecessary urinary catheters promptly.
- Implementing this reminder can help prevent CAUTIs in general medical wards.
Background:
Urinary tract infections are a common iatrogenic infection in healthcare institutions. Catheter-associated urinary tract infections (CAUTIs) may result in sepsis, prolonged hospitalization, additional hospital costs, and mortality.
Purpose:
The study examined the efficacy of an indicator-based reminder of catheter removal in decreasing CAUTIs among patients in the general medical ward.
Methods:
A two-group, quasi-experimental design was used. The intervention strategies included daily implementation of the indicator-based reminder procedure and standardized Foley care and a teaching program for all staff nurses. All patients who received Foley during hospitalization were included, with the exception of those with CAUTI at admission. Seventy-five patients were enrolled from five wards in a medical center, with 33 assigned to the control group and 42 assigned to the experimental group.
Results:
CAUTIs were diagnosed in 7 participants (16.7%) in the experimental group and 15 participants (45.5%) in the control group. The differences were statistically significant (p = .014). The mean number of Foley days was 14.73% less in the experimental group, with 11.0 for the experimental group and 12.9 for the control group. The incidence density of CAUTIs was 15.2% for the experimental group and 35.3% for the control group.
Conclusions:
The present study supports that an indicator-based reminder of catheter removal decreases the incidence rate and incidence density of CAUTIs. Medical personnel in the general medical ward may use this reminder to detect unnecessary indwelling of urinary catheters and to remove Foley catheters as early as feasible in order to prevent CAUTIs.
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