Training nurses and healthcare support staff to reduce urinary catheter use where possible has the knock-on effect of helping to reduce infection risk, according to US researchers.
Results from an initiative in Nebraska were presented this week at a conference of the Association for Professionals in Infection Control and Epidemiology in Baltimore, Maryland.
A multidisciplinary team at a 300 bed hospital reduced catheter associated urinary tract infections (CAUTIs) by 89% over a 14-month period after introducing new protocols designed to reduce catheter use, according to an abstract presented at the conference.
The team – including nurses, occupational and physical therapists, case managers and education staff – worked to decrease the use of catheters, discontinuing their use unless clinically necessary.
For example, they identified underlying reasons for catheter use when necessity was in question. These included where patients had been admitted to rehabilitation settings from acute care facilities with catheters in place, and patients whose families viewed catheters as a more convenient way to manage incontinence.
In cases where urinary catheters were required, the team educated other nursing staff, family members and patients on best practice to reduce the chance of infection.
Bladder management protocols and standards were also improved, with the intention of balancing the requirements of the patient with the need for patients to be infection-free. The appropriateness of each catheter was continually re-assessed.
Infection prevention nurse Kristina Felix, who led the initiative, said: “We looked at every facet of bladder management, including better ways to assist patients to the bathroom in a timely manner, different types of commodes and engaging the entire care team in the bladder management processes.”
She added: “We implemented education with all members of the care team, including patients and family members, so that everyone understood the process and the benefit to the patient of reduced UTIs.”
Ms Felix estimated that their program prevented up to 30 UTIs per month.
When the project was initiated in February 2010 the CAUTI prevalence rate was 36.6%, but dropped to 6.6% three months later. The original pilot concluded in April 2011.