Catheter-associated urinary tract infections in intensive care units can be reduced by prompting physicians to remove unnecessary catheters

Wei Chun Huang, Shue Ren Wann, Shoa Lin Lin, Calvin M. Kunin, Ming Ho Kung, Chin Hsun Lin, Chien Wei Hsu, Chun Peng Liu, Susan Shin Jung Lee, Yung Ching Liu, Kwok Hung Lai, Tzu Wen Lin

Research output: Contribution to journalArticle

115 Citations (Scopus)

Abstract

OBJECTIVE: Indwelling urinary catheters are the most common source of infections in intensive care units (ICUs). The aim of this study was to evaluate the efficacy of nurse-generated daily reminders to physicians to remove unnecessary urinary catheters 5 days after insertion. DESIGN: A time-sequence nonrandomized intervention study. SETTING: Adult ICUs (medical, surgical, cardiovascular surgical, neurosurgical, and coronary care) of a tertiary-care university medical center. PATIENTS: All patients admitted to the adult ICUs during a 2-year period. The study consisted of a 12-month observational phase (15,960 patient-days) followed by a 12-month intervention phase (15,525 patient-days). INTERVENTION: Daily reminders to physicians from the nursing staff to remove unnecessary urinary catheters 5 days after insertion. RESULTS: The duration of urinary catheterization was significantly reduced during the intervention phase (from 7.0 ± 1.1 days to 4.6 ± 0.7 days; P <.001). The rate of catheter-associated urinary tract infection (CAUTI) was also significantly reduced (from 11.5 ± 3.1 to 8.3 ± 2.5 patients with CAUTI per 1,000 catheter-days; P = .009). There was a linear relationship between the monthly average duration of catheterization and the rate of CAUTI (r = 0.50; P = .01). The excess monthly cost of antibiotics for CAUTI was reduced by 69% (from $4,021 ± $1,800 to $1,220 ± $941; P = .004). CONCLUSION: This study demonstrated that a simple measure instituted as part of a continuous quality improvement program significantly reduced the duration of urinary catheterization, rate of CAUTI, and additional costs of antibiotics to manage CAUTI.

Original languageEnglish
Pages (from-to)974-978
Number of pages5
JournalInfection Control and Hospital Epidemiology
Volume25
Issue number11
DOIs
Publication statusPublished - Nov 2004
Externally publishedYes

Fingerprint

Catheter-Related Infections
Urinary Tract Infections
Intensive Care Units
Catheters
Physicians
Urinary Catheters
Urinary Catheterization
Anti-Bacterial Agents
Costs and Cost Analysis
Indwelling Catheters
Nursing Staff
Tertiary Healthcare
Quality Improvement
Catheterization
Nurses
Infection

ASJC Scopus subject areas

  • Microbiology (medical)
  • Immunology

Cite this

Catheter-associated urinary tract infections in intensive care units can be reduced by prompting physicians to remove unnecessary catheters. / Huang, Wei Chun; Wann, Shue Ren; Lin, Shoa Lin; Kunin, Calvin M.; Kung, Ming Ho; Lin, Chin Hsun; Hsu, Chien Wei; Liu, Chun Peng; Lee, Susan Shin Jung; Liu, Yung Ching; Lai, Kwok Hung; Lin, Tzu Wen.

In: Infection Control and Hospital Epidemiology, Vol. 25, No. 11, 11.2004, p. 974-978.

Research output: Contribution to journalArticle

Huang, WC, Wann, SR, Lin, SL, Kunin, CM, Kung, MH, Lin, CH, Hsu, CW, Liu, CP, Lee, SSJ, Liu, YC, Lai, KH & Lin, TW 2004, 'Catheter-associated urinary tract infections in intensive care units can be reduced by prompting physicians to remove unnecessary catheters', Infection Control and Hospital Epidemiology, vol. 25, no. 11, pp. 974-978. https://doi.org/10.1086/502329
Huang, Wei Chun ; Wann, Shue Ren ; Lin, Shoa Lin ; Kunin, Calvin M. ; Kung, Ming Ho ; Lin, Chin Hsun ; Hsu, Chien Wei ; Liu, Chun Peng ; Lee, Susan Shin Jung ; Liu, Yung Ching ; Lai, Kwok Hung ; Lin, Tzu Wen. / Catheter-associated urinary tract infections in intensive care units can be reduced by prompting physicians to remove unnecessary catheters. In: Infection Control and Hospital Epidemiology. 2004 ; Vol. 25, No. 11. pp. 974-978.
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abstract = "OBJECTIVE: Indwelling urinary catheters are the most common source of infections in intensive care units (ICUs). The aim of this study was to evaluate the efficacy of nurse-generated daily reminders to physicians to remove unnecessary urinary catheters 5 days after insertion. DESIGN: A time-sequence nonrandomized intervention study. SETTING: Adult ICUs (medical, surgical, cardiovascular surgical, neurosurgical, and coronary care) of a tertiary-care university medical center. PATIENTS: All patients admitted to the adult ICUs during a 2-year period. The study consisted of a 12-month observational phase (15,960 patient-days) followed by a 12-month intervention phase (15,525 patient-days). INTERVENTION: Daily reminders to physicians from the nursing staff to remove unnecessary urinary catheters 5 days after insertion. RESULTS: The duration of urinary catheterization was significantly reduced during the intervention phase (from 7.0 ± 1.1 days to 4.6 ± 0.7 days; P <.001). The rate of catheter-associated urinary tract infection (CAUTI) was also significantly reduced (from 11.5 ± 3.1 to 8.3 ± 2.5 patients with CAUTI per 1,000 catheter-days; P = .009). There was a linear relationship between the monthly average duration of catheterization and the rate of CAUTI (r = 0.50; P = .01). The excess monthly cost of antibiotics for CAUTI was reduced by 69{\%} (from $4,021 ± $1,800 to $1,220 ± $941; P = .004). CONCLUSION: This study demonstrated that a simple measure instituted as part of a continuous quality improvement program significantly reduced the duration of urinary catheterization, rate of CAUTI, and additional costs of antibiotics to manage CAUTI.",
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T1 - Catheter-associated urinary tract infections in intensive care units can be reduced by prompting physicians to remove unnecessary catheters

AU - Huang, Wei Chun

AU - Wann, Shue Ren

AU - Lin, Shoa Lin

AU - Kunin, Calvin M.

AU - Kung, Ming Ho

AU - Lin, Chin Hsun

AU - Hsu, Chien Wei

AU - Liu, Chun Peng

AU - Lee, Susan Shin Jung

AU - Liu, Yung Ching

AU - Lai, Kwok Hung

AU - Lin, Tzu Wen

PY - 2004/11

Y1 - 2004/11

N2 - OBJECTIVE: Indwelling urinary catheters are the most common source of infections in intensive care units (ICUs). The aim of this study was to evaluate the efficacy of nurse-generated daily reminders to physicians to remove unnecessary urinary catheters 5 days after insertion. DESIGN: A time-sequence nonrandomized intervention study. SETTING: Adult ICUs (medical, surgical, cardiovascular surgical, neurosurgical, and coronary care) of a tertiary-care university medical center. PATIENTS: All patients admitted to the adult ICUs during a 2-year period. The study consisted of a 12-month observational phase (15,960 patient-days) followed by a 12-month intervention phase (15,525 patient-days). INTERVENTION: Daily reminders to physicians from the nursing staff to remove unnecessary urinary catheters 5 days after insertion. RESULTS: The duration of urinary catheterization was significantly reduced during the intervention phase (from 7.0 ± 1.1 days to 4.6 ± 0.7 days; P <.001). The rate of catheter-associated urinary tract infection (CAUTI) was also significantly reduced (from 11.5 ± 3.1 to 8.3 ± 2.5 patients with CAUTI per 1,000 catheter-days; P = .009). There was a linear relationship between the monthly average duration of catheterization and the rate of CAUTI (r = 0.50; P = .01). The excess monthly cost of antibiotics for CAUTI was reduced by 69% (from $4,021 ± $1,800 to $1,220 ± $941; P = .004). CONCLUSION: This study demonstrated that a simple measure instituted as part of a continuous quality improvement program significantly reduced the duration of urinary catheterization, rate of CAUTI, and additional costs of antibiotics to manage CAUTI.

AB - OBJECTIVE: Indwelling urinary catheters are the most common source of infections in intensive care units (ICUs). The aim of this study was to evaluate the efficacy of nurse-generated daily reminders to physicians to remove unnecessary urinary catheters 5 days after insertion. DESIGN: A time-sequence nonrandomized intervention study. SETTING: Adult ICUs (medical, surgical, cardiovascular surgical, neurosurgical, and coronary care) of a tertiary-care university medical center. PATIENTS: All patients admitted to the adult ICUs during a 2-year period. The study consisted of a 12-month observational phase (15,960 patient-days) followed by a 12-month intervention phase (15,525 patient-days). INTERVENTION: Daily reminders to physicians from the nursing staff to remove unnecessary urinary catheters 5 days after insertion. RESULTS: The duration of urinary catheterization was significantly reduced during the intervention phase (from 7.0 ± 1.1 days to 4.6 ± 0.7 days; P <.001). The rate of catheter-associated urinary tract infection (CAUTI) was also significantly reduced (from 11.5 ± 3.1 to 8.3 ± 2.5 patients with CAUTI per 1,000 catheter-days; P = .009). There was a linear relationship between the monthly average duration of catheterization and the rate of CAUTI (r = 0.50; P = .01). The excess monthly cost of antibiotics for CAUTI was reduced by 69% (from $4,021 ± $1,800 to $1,220 ± $941; P = .004). CONCLUSION: This study demonstrated that a simple measure instituted as part of a continuous quality improvement program significantly reduced the duration of urinary catheterization, rate of CAUTI, and additional costs of antibiotics to manage CAUTI.

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