712. Does early foley catheter removal lead to higher re-catheterization rate in patients at a Rehabilitation (Rehab) Center?
Session: Poster Abstract Session: UTIs - Epidemiology and Prevention
Friday, October 21, 2011
Room: Poster Hall B1
Background: Prolonged duration of foley catheterization is a known risk factor for catheter associated urinary tract infections (CAUTI) yet physicians hesitate to discontinue a foley catheter if it was ordered by another physician or facility. We designed a project to study the difference in re-catheterization rate of patients with early versus delayed catheter removal at a Rehab Center.

Methods: A retrospective chart review was performed on all adult patients admitted to a 75 bed rehab facility over a period of one year (9/09 to 10/10) who had an indwelling foley during their stay. Data collection included demographics, foley placement, indications and discontinuation records. The group of patients who had their foley removed within 2 days of admission or placement (early discontinuation) were compared with the group who had it for > 2 days (prolonged placement) using either Pearson Chi-square or Fisher's Exact test.

Results: Among 160 patients (mean age 62 years, 55% male, 72% Caucasian, 27% African American) who had an indwelling foley during their rehab stay, most (122) had it in place on admission. Physiologic or anatomic outflow obstruction was the leading indication listed for initial foley (78%), followed by pressure ulcer (5%), input & output monitoring (5%), genitourinary surgery (1%) and comfort for patient in palliative care (1%). Documentation of appropriate indication was lacking in 10% of cases. Nearly half of these patients (47%) had their foley removed within 2 days of admission. There was no significant difference in the rate of re-catheterization for the group (n=65) who had early discontinuation of first foley (35.9%) compared to the group (n=95) with prolonged placement (28.5% ; p=0.36). Similarly, no significant difference was found in the rate of early re-catheterization (i.e., within 2 days of removal of first foley) between these groups (17.1% vs. 10%, p=0.23).

Conclusion: Our study should provide assurance to the rehab physicians that early removal of the initial foleys in this population does not put them at increased risk for re-catheterization and will likely reduce their risk for CAUTI. Future infection control programs should focus on identifying patients whose foley catheter may be discontinued even before their admission to rehab.


Subject Category: N. Hospital-acquired and surgical infections, infection control, and health outcomes including general public health and health services research

Muhammad Salman Ashraf, MD1, Vicki Kinzie, RN, BSN2, Naureen Sheikh, MD3, M. Kathy Cochran, RN, MS, CIC2, Xiangming Fang, PhD4, Clinton Faulk, MD4 and Keith M. Ramsey, MD2,5, (1)Infectious Disease, Brody School of Medicine, East Carolina University, Greenville, NC, (2)Pitt County Memorial Hospital, Greenville, NC, (3)Pitt County Memorial Hospital/East Carolina University, Greenville, NC, (4)East Carolina University, Greenville, NC, (5)The Brody School of Medicine at ECU, Greenville, NC

Disclosures:

M. S. Ashraf, None

V. Kinzie, None

N. Sheikh, None

M. K. Cochran, None

X. Fang, None

C. Faulk, None

K. M. Ramsey, None

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