Methods: There was a point prevalence survey conducted in 2 days (March 24-25, 2015). We included all patients aged ≥ 18 years admitted in a 500-bed university-affiliated, tertiary care hospital in Bangkok and had UCs in place on the day of our survey. We recorded data using CDC definition in device-associated module for Catheter Associated Urinary Tract Infection (CAUTI).
Results: Of 330 patients observed, 67 (20.3%) cases had UCs in place. Thirty-one (46.3%) of them had inappropriate indications. Overall catheter-day was 1,754 that had 794 catheter-day of unnecessary (45.3%). We found higher number of cases having inappropriate indication on their current date of catheterization than on the date of insertion (31 cases (46.3%) vs. 8 cases (11.9%), p=0.001). Patients in Medicine Department had higher appropriateness of UC used compared with others (OR 3.6, 95% CI 1.30-9.98, p=0.01). In the department, majority of the appropriateness (25/39 cases, 69.4%) were to monitor critically ill patients while most of inappropriateness (10/13 cases, 76.9%) were to evaluate volume status in non-critical ones. Unneccessry fluid monitoring was also a common indication of indwelling urinary catheterization among patients in Surgical Department (17/22 cases, 37.0%), mostly in neurology (61.5%). Convenience of care was the most common reason in Orthopedic Department (4/6 cases, 66.7%). No difference in symptomatic CAUTI rate was observed between inappropriate and appropriate used of UC (6.6 vs. 5.0 cases per 1,000 catheter-days) under the same compliance rate of CAUTI-prevention bundle (72.7% vs. 75.0%, p=0.84).
Conclusion: Overused of UC is a common problem in all hospitals. Despite small numbers of observation in our surveillance, we found different focus groups in our hospital. Tailor-made intervention should be performed in each department to achieve our goal in decreasing inappropriate used of UC.
A. Sricharoon, None
D. Chatngern, None
K. Thongyen, None
C. Tantimongkolsuk, None