709. Catheter-Associated Urinary Tract Infections: Surveillance and Prevention
Session: Poster Abstract Session: UTIs - Epidemiology and Prevention
Friday, October 21, 2011
Room: Poster Hall B1
Background: 

Urinary tract infections (UTIs) are a common hospital acquired infection and are often attributable to an indwelling urinary catheter.  We assessed the impact of a nursing-physician intervention on increasing appropriate catheter use, reducing duration of urinary catheterization and decreasing rates of catheter-associated UTI (CAUTI).

Methods: 

We conducted a prospective cohort study on four general medicine units.  During the baseline period from 11/09-12/09, we collected basic demographic, urinary catheter and microbiological data in patients with a urinary catheter. During the intervention period from 11/10-12/10, nurses on two of the units made daily assessments of the indication for urinary catheter placement and communicated with the physician regarding catheter discontinuation.  The other two units served as concurrent controls.

Results: 

During the baseline and intervention period, there were 201 and 180 patient encounters with a urinary catheter, respectively.  Patients in the surveillance period and intervention period were similar with respect to sex and hospital length of stay, but patients in the intervention units were on average older (73 vs 70, p=0.04).  In the intervention units, more catheterized patients had a valid indication for urinary catheter placement during the intervention period than during the baseline period (84% vs 68%, p=0.001). There was no difference among the control units (68% vs. 64%, p=0.65).  In the intervention units, more catheterized patients had an order for the catheter during the intervention than the baseline period (62% vs. 44%, p=0.003). There was no difference on control units (42% vs. 51%, p=0.35).  There was no significant difference among intervention units or control units with regards to average catheter duration (6.1 vs. 6.2 days, p=0.50; 5.6 vs. 5.5 days, p=0.93) or number of symptomatic urinary tract infections (15% vs. 6%, p=0.14; 6% vs. 5%, p=0.91) between the two study periods.

Conclusion: 

A nursing-physician intervention was effective in improving documentation of an appropriate urinary catheter indication and order placement for a urinary catheter; however, there was no significant difference in catheter duration or number of symptomatic urinary tract infections.  


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

Meenakshi M. Rana, MD1, Gopi Patel, MD1, Susan Davis, DNP, MPH, RN2, Hourig Karalian, MSN, RN2, Maxine Shepherd, MSN, RN2, Jane Gonzales, MA, RN2, Angelina Begonia, MS, RN, CCRN, ACNP-BC2 and David P. Calfee, MD3, (1)Mount Sinai School of Medicine, New York, NY, (2)Mount Sinai Hospital, New York, NY, (3)Weill Cornell Medical College, New York, NY

Disclosures:

M. M. Rana, None

G. Patel, None

S. Davis, None

H. Karalian, None

M. Shepherd, None

J. Gonzales, None

A. Begonia, None

D. P. Calfee, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.