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Implementation of a Nurse-Driven Protocol for Catheter Removal to Decrease Catheter-Associated Urinary Tract
Anna F Tyson1, Eileen F Campbell2, Lacey R Spangler1
1Department of General Surgery, Carolinas Medical Center, Charlotte, NC, USA.
Journal of Intensive Care Medicine
|June 12, 2018
Summary
A nurse-directed protocol for early urinary catheter removal significantly reduced catheter use and catheter-associated urinary tract infections (CAUTI) in a surgical trauma intensive care unit. This strategy is effective for CAUTI prevention.
Area of Science:
- Infectious Disease Prevention
- Critical Care Medicine
- Nursing Practice
Background:
- Early urinary catheter removal is a key strategy for preventing catheter-associated urinary tract infections (CAUTI).
- A nurse-directed protocol was hypothesized to decrease catheter utilization and CAUTI rates in a surgical trauma intensive care unit (STICU).
Purpose of the Study:
- To evaluate the impact of a nurse-directed urinary catheter removal protocol on catheter utilization and CAUTI rates.
- To assess the effectiveness of a multimodal CAUTI prevention bundle in a STICU setting.
Main Methods:
- A retrospective cohort study compared a 19-month preintervention period with a 15-month postintervention period.
- Data on indwelling catheter utilization and CAUTI rates were collected before and after protocol implementation.
- Statistical analysis compared pre- and postintervention rates.
Main Results:
- Catheter utilization decreased significantly from 0.78 to 0.70 per patient-day (P < .05).
- CAUTI rates declined significantly from 5.1 to 2.0 infections per 1000 catheter-days (IRR: 0.38).
Conclusions:
- Implementing a nurse-driven protocol for early urinary catheter removal is an effective component of multimodal CAUTI prevention.
- This strategy leads to measurable reductions in both urinary catheter utilization and CAUTI rates in intensive care units.
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