Using a multifaceted intervention, hospitals can decrease catheter-associated urinary tract infections in cardiovascular surgery patients, according to a study published in the American Journal of Infection Control.
To assess the impact of a multifaceted intervention on CAUTI incidence, the urinary catheter utilization ratio, and adherence to indwelling urinary catheter use recommendations, the researchers conducted their interventional study in three 6-month phases: preintervention (phase 1), intervention (phase 2) and postintervention (phase 3).
They examined indwelling urinary catheter insertion technique, maintenance care and removal and nonremoval practices. They also provided training on CAUTI prevention measures, evaluated professional knowledge, provided adherence feedback, determined the incidence of CAUTI and calculated the urinary catheter utilization ratio.
Ultimately, they made the following three discoveries.
1. Between the first and third phases, CAUTI incidence fell from 11.42 cases per 1,000 catheter days to 4.40 cases per 1,000 catheter days. The urinary catheter utilization ratio remained constant, however.
2. The risk of CAUTI was 2.6 times higher in phase 1 than in phase 3. The drop in CAUTI risk during the course of the study may be attributable to a significant improvement in hand hygiene compliance (before and after indwelling urinary catheter insertion) and adherence to maintenance care guidelines regarding attaching the indwelling urinary catheter to the patient.
3. The reasons for indwelling urinary catheter use — including inappropriate reasons — did not differ significantly throughout the study. That said, training did significantly improve professional knowledge.
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