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Success of a urinary catheter insertion team in reducing urinary infections in the ICU

Introduction

About 8-21 % of hospital infections in ICUs are urinary [1, 2], 80 % of them being associated with the use of urinary catheters [3]. Several studies show that the early removal of urinary catheters reduces the rate of urinary tract infection. However, critically ill patients who require this device do not have the option to remove. For this group, the best preventive measure seems to be educative activity for the nursing staff responsible for the insertion and manipulation of this device.

Objective

To create a team of professionals trained in the insertion of urinary catheters and to organize actions aimed at reducing the rate of urinary tract infection associated with urinary catheters in the ICU.

Methods

Prospective study conducted for 12 months in the ICU. Started in July 2013, the intervention program involved the creation of a qualified team for the insertion of urinary catheter and the creation of audits to stimulate the removal of inappropriate urinary catheters and assess the process of inserting these devices. The obtained results were compared with the 12 months preceding the beginning of the interventions.

Results

Comparison between August 2012-July 2013 and August 2013-July 2014 (Table 1, Figures 1 and 2) shows that there was a fall of 57.2 % (2.4-1.0, p = 0.040) in the rate of urinary tract infection associated with a urinary catheter and a reduction of 13.4 % (from 0.24 to 0.21, p = 0.001) in the utilization rate of urinary catheters. In the 12 months after intervention (August 2013-July 2014) the percentage of compliance of technical insertion of urinary catheter was 97 % and the inappropriate removal rate of urinary catheters was 85 % (Table 2).

Table 1 Incidence density ratio urinary tract infection and utilization ratio urinary catheter before and after interventions according to the location.
Figure 1
figure1

Incidence density ratio of urinary tract infections before and after interventions.

Figure 2
figure2

Utilization rate of urinary catheters before and after interventions.

Table 2 Results of audited items between August 2013 and July 2014.

Conclusion

The results show that low-cost educational interventions can reduce urinary infections and provide more security for patients in ICUs.

References

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    Eriksen HM, Iversen BG, Aavitsland P: Prevalence of nosocomial infections in hospitals in Norway, in 2002 and 2003. J Hosp Infect. 2005, 40-5. 60

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    Lizioli A, Privitera G, Alliata E, Antonietta Banfi IN, Boselli L, Panceri ML, et al: Prevalence of nosocomial infections in Italy: result from the Lombardy survey in 2000. J Hosp Infect. 2003, 54: 141-8. 10.1016/S0195-6701(03)00078-1.

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Correspondence to Deianira Regagnin.

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Regagnin, D., Silva Alves, D.S.d. & Guastelli, L.R. Success of a urinary catheter insertion team in reducing urinary infections in the ICU. Crit Care 19, P44 (2015). https://doi.org/10.1186/cc14690

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Keywords

  • Catheter
  • Urinary Tract Infection
  • Emergency Medicine
  • Intervention Program
  • Removal Rate