(HealthDay News) — A new program may help reduce both urinary catheter use and its associated infections, according to research findings published in the New England Journal of Medicine.
Sanjay Saint, MD, MPH, professor of internal medicine at the University of Michigan in Ann Arbor, and colleagues tried the new program in 600 hospitals. The program Saint helped develop — called the “bladder bundle” — includes protocols, checklists, training, and information-sharing that help doctors and nurses reduce catheter use and prevent infections. Included in the program are: Daily checks to see if a catheter is still needed; using other options to collect urine, such as bedpans; training for managing urinary catheters; use of infection-control techniques for catheter placement and maintenance; and feedback to the medical team about catheter use and infection rates.
The researchers found that catheter-associated urinary tract infection (UTI) rates decreased from 2.40 to 2.05 infections per 1000 catheter-days (incidence rate ratio, 0.86), in an unadjusted analysis. Among non-intensive care units (ICUs), catheter use decreased from 20.1 to 18.8% and catheter-associated UTI rates decreased from 2.28 to 1.54 infections per 1000 catheter-days.There was no change in infections or catheter use in ICUs. Hospital-acquired UTI rates rose nationwide during the same time period, Saint noted.
Susan Huang, MD, MPH, a professor of infectious disease at the University of California, Irvine, wrote an editorial accompanying the study. She told HealthDay that “while we’ve known the correct care processes for managing urinary catheters, we haven’t been able to reliably reduce catheter-related infections.” An intervention that focuses on changing the culture in hospitals to make them more responsive to the problem of infection control — one that involves “rallying around a focused problem and ensuring team-based solutions — is integral to improving infection control in hospitals,” she said.
1. Saint S, Greene MT, Krein SL, et al.A Program to Prevent Catheter-Associated Urinary Tract Infection in Acute Care. N Engl J Med 2016; 374:2111-2119. doi: 10.1056/NEJMoa1504906.
2. Huang SS. Catheter-Associated Urinary Tract Infections — Turning the Tide. N Engl J Med 2016; 374:2168-2169. doi: 10.1056/NEJMe1604647.