290. Hospital-wide Point Prevalence Survey of Inappropriate Use of Urinary Catheterization: Indications and Consequences
Session: Poster Abstract Session: HAI: Device Associated Infections
Thursday, October 8, 2015
Room: Poster Hall
Posters
  • IDWeek 2015_poster.pdf (266.2 kB)
  • Background:    The study examined risk factors and results of the inappropriate use of urinary catheterization (UC) among hospitalized patients.

    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.

    Pasri Maharom, MD, MPH, Apanaree Bhekasuta, MD, Aungsumalin Sricharoon, BNS, Duangkamol Chatngern, BNS, MS, Kaimuk Thongyen, BNS and Chirapan Tantimongkolsuk, MD, Somdech Phra Pinklao Hospital, Naval Medical Department, Bangkok, Thailand

    Disclosures:

    P. Maharom, None

    A. Bhekasuta, None

    A. Sricharoon, None

    D. Chatngern, None

    K. Thongyen, None

    C. Tantimongkolsuk, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.