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Catheter-free geriatric care. Routines and consequences for clinical infection, care and economy
Insights
Removing indwelling catheters from geriatric patients improved outcomes. Catheter-free care reduced antibiotic use by 90% and costs by 46%, with positive staff and patient feedback.
Area of Science:
- Geriatric Medicine
- Infectious Disease Prevention
- Nursing Care Improvement
Background:
- Indwelling urinary catheters are common in geriatric patients.
- Catheter use is associated with increased infection rates and healthcare costs.
- Alternative continence management strategies are needed.
Purpose of the Study:
- To evaluate the feasibility and impact of removing indwelling catheters in a geriatric hospital ward.
- To assess the effects of a catheter-free care program on patient outcomes, staff attitudes, and resource utilization.
Main Methods:
- Implementation of a continence training program.
- Modification of ward routines to remove indwelling catheters from admitted patients.
- Comparison with control wards over an 18-month period.
Main Results:
- Catheter removal was successful in 117 out of 124 patients.
- Significant reduction in antibiotic prescriptions (90%) and healthcare costs (46%).
- Positive patient, relative, and staff attitudes towards catheter-free care.
Conclusions:
- Catheter-free care is feasible and beneficial in a geriatric hospital setting.
- This approach leads to reduced antibiotic use, lower costs, and improved patient and staff satisfaction.
- Continence training programs are effective in supporting catheter removal.
Abstract:
In a geriatric hospital the routines of one ward were modified with the intention of removing indwelling catheters from all patients admitted to the ward. A continence training programme had been designed during the preceding 6 months. A total of 124 patients were admitted with indwelling catheters during a period of 18 months. It was possible to remove the catheters in 117 of these. Patients and their relatives reacted favourably to catheter-free care. The attitude of ward staff also was positive. The overall nursing requirements did not increase. Antibiotic prescription was 90 per cent less than in the control wards. This difference was accounted for not only by a reduction in drugs used against urinary tract infections, but also by a lower consumption of agents mainly used in the treatment of septicaemia, bronchopneumonia and wound infection. The cost of laundry and of hygiene and storage articles, including catheters, absorbing pads and other incontinence aids was 46 per cent of that in the control wards. Four years later, 65 per cent and 72 per cent of the patients from the test and control wards respectively, had died. Of the surviving patients from the test ward 78 per cent were still catheter-free.
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