295. Effectiveness of a Daily Verbal Reminder to Decrease the Duration of Indwelling Urinary Catheter Use
Session: Poster Abstract Session: HAI: Device Associated Infections
Thursday, October 8, 2015
Room: Poster Hall
Posters
  • CAUTI QI Poster Final.png (578.5 kB)
  • Background: Reminders to clinicians regarding urinary catheter removal have been effective in reducing the rate of catheter-associated urinary tract infections (CAUTI). Both nurse-initiated and physician-initiated verbal reminders showed significantly decreased duration of catheterization and rates of CAUTI but have not been compared directly.

    We initiated as a quality improvement project in two New York City hospitals, a comparison of nurse-initiated with physician-initiated daily verbal reminders to remove unnecessary urinary catheters.

    Methods: At two hospitals in New York City from May 1 to June 6, 2014, inpatients on the medical service (excluding ICUs) who had an indwelling urinary catheter were identified daily and alternately assigned to an MD or nurse intervention group. Patients who had documentation of appropriate indications for catheter use were excluded. An MD or infection control nurse would contact the medical team and question the need for continued catheter use daily until the catheter was removed or hospitalization ended. Additional patients for whom no care provider was contacted formed the control group. For the intervention groups, days of catheter use after intervention (in days) and for controls total duration minus the average time between catheter insertion and intervention in the other groups were compared.

    Results: 22 patients were assigned to the MD group, 21 to the RN group, and 11 to the control group. Sixty-nine percent of patients were female and 81% were >64 years old. There were no differences in demographics between groups. Post-intervention catheter mean (+SD) duration in the MD group was 0.545 + 0.80 days compared to controls at 2.67 + 3.23 days (P=0.0027) and to the RN group at 1.67 + 2.74 days (P=0.03). There was a trend towards a decrease in post-intervention catheter days comparing the RN group to control which did not reach statistical significance (P=0.12).

    Conclusion: Daily verbal reminders are a useful adjunct in reducing unnecessary urinary catheter use. This study showed the duration of catheter use was significantly decreased if an MD performed the reminder compared to an infection control nurse. Further studies are needed to determine the cost-effectiveness of this approach to preventing CAUTIs.

    Logan Felix, MD1, Barbara Smith, RN, BSN, MPA, CIC2, Eloisa Santos, RN, BSN, MA, MEd, CIC3, Angela Gabasan, RN, BSN, MSN, CIC2, Olena Dzenkevych, MS4, Ismini Kourouni, MD5 and Robert Klein, MD, FIDSA1, (1)Division of Infectious Diseases, Mount Sinai St. Luke's Hospital and Mount Sinai Roosevelt Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, (2)Infection Control, Mount Sinai St. Luke's Hospital, New York, NY, (3)Infection Control, Mount Sinai Roosevelt Hospital, New York, NY, (4)Infection Control, Mount Sinai St. Luke's Hospital and Mount Sinai Roosevelt Hospital, New York, NY, (5)Department of Medicine, Mount Sinai St. Luke's Hospital and Mount Sinai Roosevelt Hospital, Icahn School of Medicine at Mount Sinai, New York, NY

    Disclosures:

    L. Felix, None

    B. Smith, None

    E. Santos, None

    A. Gabasan, None

    O. Dzenkevych, None

    I. Kourouni, None

    R. Klein, 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.