201. Successful Reduction in Urinary Catheter Use in Patients Transferred out of the Intensive Care Units with Staff Education and Engagement
Session: Poster Abstract Session: Catheter-associated UTIs
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • ICU UC Intervention ID week 2013.pdf (644.3 kB)
  • Background:

    Avoiding catheter exposure is key to reduce catheter-associated urinary tract infections. Urinary catheter (UC) utilization is nearly four times greater in the intensive care unit (ICU) compared to the non-ICU, making it important to address UC need at the time of transfer out from the ICU.

    Methods: The study employed a pre-post quasi-experimental design. We evaluated 3 periods: period 1 (no intervention, March 2012), period 2 (heightened awareness by staff of importance for catheter evaluation, September 2012), and period 3 (educational intervention with audits and feedback, November 15th-December 14th, 2012). A 3rdyear medical resident educated resident physicians and nurses regarding indications for use and the evaluation of catheter need prior to transfer out of ICU (formal presentation and provided educational materials on pocket cards). In addition, random audits and feedback were provided to the ICU staff. Data included catheter utilization, and the number of patients who had the catheter discontinued before transfer out of ICU.

    Results:

    490 patients were treated over the 3 periods. UC utilization was 0.72, 0.73, and 0.64 for the 3 consecutive periods (periods 1 vs.3 p=0.004; 2 vs. 3 p=0.004). The UC was discontinued before transfer out of ICU in 14.2% (21/148) period 1, 15% (15/100) period 2, and 25.5% (25/98) period 3 (p=0.03 for periods 1 vs. 3; p=0.07 for periods 2 vs. 3). Patients had the UC discontinued prior to transfer out of ICU in 14.5% (36/248) for combined periods 1-2 compared to 25.5% (25/98) for period 3 (p=0.02).

    Conclusion:

    Education on appropriate UC use and random audits evaluating presence and catheter need are associated with higher discontinuation of UCs prior to transfer out of ICU. Continuous engagement of staff in safety processes is crucial for successful results.

    Babak Hooshmand, M.D, Internal Medicine, St. John Hospital and Medical Center, Detroit, MI, Susan Szpunar, PhD, Graduate Medical Education, St. John Hospital and Medical Center, Grosse Pointe Woods, MI and Mohamad Fakih, MD, MPH, Infection Prevention and Control, St. John Hospital and Medical Center, Grosse Pointe Woods, MI

    Disclosures:

    B. Hooshmand, None

    S. Szpunar, None

    M. Fakih, None

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