531. A Simple Intervention to Achieve Appropriate Urinary Catheter Use in a University-Affiliated Community Hospital
Session: Poster Session: Hospital-acquired and Transplant Infections
Friday, October 30, 2009: 12:00 AM
Room: Poster Hall A
Background: Catheter-associated urinary tract infection (CA-UTI) is the most common site of healthcare-associated infection. Of these infections, 80% follow instrumentation of the urinary tract. It is believed that a large number could be avoided by proper management of catheter use. Objective was to assess the effectiveness of an intervention to increase appropriate urinary catheter use.
Methods: Prior to the intervention, the percentage of patients who met criteria for appropriate catheter use and the number of patients with CA-UTI were obtained. A reminder sticker was placed on the binder of the patient’s medical record to remind the physician to consider discontinuing the inappropriate catheter. Percentage of appropriate catheter use was collected in December 2008 and March 2009, 3 months and 6 months post-intervention respectively, as a primary outcome. During the same period of time, the number of patients with CA-UTI was collected pre-intervention, 3 month and 6 months post-intervention as a secondary outcome.
Result: Prior to the intervention, the number of patients with appropriate urinary catheter was 57% and the rate of CA-UTI was 7.41 infections per 1,000 catheter-days. Post-intervention, the number was 73% in December 2008 and 86% in March 2009 respectively. As a primary outcome, there was a statistically significant increase in the number of appropriate urinary catheters (57% vs. 73% [P = 0.007] and 57 % vs. 86% [P< 0.001], respectively). The rate of CA-UTI was 2.08 infections per 1,000 catheter-days in December 2008 and 2.72 infections per 1,000 catheter-days in March 2009 respectively. As a secondary outcome, there was not a statistically significant reduction in the rate of CA-UTI in December 2008 (7.02 vs. 2.08 [P=0.11]) and March 2009 (7.02 vs. 2.72 [P=0.89]).
Conclusion: A simple intervention using a sticker placed on the patient's medical record binder to remind physicians to promptly removal of unnecessary urinary catheters can significantly increase appropriate urinary catheter use.
Jackrapong Bruminhent, MD1, Marjorie Keegan, RN1, Joanne Passalacqua, MD1 and  J. Bruminhent, None..
M. Keegan, None..
J. Passalacqua, None., (1)St. Vincent's Medical Center, Bridgeport, CT