202. A Multidisciplinary Campaign Improves Physician Knowledge of Appropriate Indications for Urinary Catheters and Decreases Urinary Catheter Utilization
Session: Poster Abstract Session: Catheter-associated UTIs
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
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  • Background: Catheter-associated urinary tract infections (CAUTIs) are the most common healthcare-associated infection. Physician knowledge of urinary catheter placement indications is typically poor and urinary catheters are often used without an appropriate indication.  In our large public teaching hospital, we developed a CAUTI task force to implement a hospital-wide, multidisciplinary campaign to improve providers’ knowledge of indications for urinary catheters and to decrease urinary catheter utilization.

    Methods: In December 2012, the Harbor-UCLA Medical Center CAUTI Task Force, a multidisciplinary team comprised of nurses and physicians, implemented a campaign that included physician and nurse education on appropriate indications for urinary catheters, automatic stop orders for urinary catheters in patients without an indication, and a requirement for documentation of continued catheter need in physician progress notes.  We assessed (1) knowledge of urinary catheter indications among 141 physicians via surveys and (2) rates or urinary catheter utilization among patients prior to and four months after the campaign.  Data analysis was conducted using a two-proportions test and chi-square test as appropriate with Fisher’s exact methods and a Cochran-Armitage Trend Test in SAS v9.3 to calculate p-values.

    Results: Physician knowledge of the correct indications for urinary catheters increased from 68% (52/76) at baseline to 83% (54/65) after the educational intervention, (p<0.05).  The proportion of physicians reporting knowing which of their patients had urinary catheters increased from a baseline of 38% (29/76) to 65% (42/65) following the intervention (p<0.001).  Additionally, monthly urinary catheter utilization decreased over a four-month period (15.3% to 12.6%, p<0.001).  Three months after our intervention, urinary catheter utilization rates were lower than published national means in 18 of 20 hospital units.

    Conclusion: We found that an innovative, multidisciplinary intervention significantly improved physician knowledge of urinary catheter indications and decreased urinary catheter utilization.  These improved process outcomes may lead to lower CAUTI rates and improved patient safety.

    Darcy Wooten, MD, MS1, Loren Miller, MD, MPH2, Samantha J. Eells, MPH3, Arlene Malabanan, RN, BSN4, Jenifer Ramsay, RN, BSN, PHN4, Susan Black, RN, MSN4 and Mallory Witt, MD5, (1)Infectious Diseases, Harbor UCLA Medical Center, Torrance, CA, (2)Harbor-University of California, Los Angeles Medical Center, Torrance, CA, (3)Division of Adult Infectious Diseases, Los Angeles Biomedical Research Institute At Harbor-UCLA Medical Center, Torrance, CA, (4)Nursing, Harbor UCLA Medical Center, Torrance, CA, (5)Harbor/UCLA Med Ctr, Torrance, CA


    D. Wooten, None

    L. Miller, None

    S. J. Eells, None

    A. Malabanan, None

    J. Ramsay, None

    S. Black, None

    M. Witt, None

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