Reducing catheter-associated urinary tract infections in the ICU

This review provides a summary of CAUTI reduction strategies that are specific to the intensive care setting | Current Opinion in Critical Care

Patients in the ICU are at higher risk for catheter-associated urinary tract infection (CAUTI) due to more frequent use of catheters and lower threshold for obtaining urine cultures.

The surveillance definition for CAUTI is imprecise and measures catheter-associated bacteriuria rather than true infection. Alternatives have been proposed, but CAUTI rates measured by this definition are currently required to be reported to the Centers for Medicare and Medicaid Services and high CAUTI rates can result in financial penalties. Although CAUTI may not directly result in significant patient harm, it has several indirect patient safety implications and CAUTI reduction has several benefits. Various bundles have been successful at reducing CAUTI both in individual institutions and on larger scales such as healthcare networks and entire states.

Full reference: Sampathkumar, P. (2017) Reducing catheter-associated urinary tract infections in the ICU. Current Opinion in Critical Care. Vol. 23 (Issue 5) pp. 372–377

 

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The value of direct observation to reduce catheter-associated urinary tract infection

Afonso, E. & Blot, S. Intensive and Critical Care Nursing | Published online: 26 April 2017

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Urinary tract catheterization and monitoring of the urinary output is indispensable in critically ill patients as might indicate intravascular circulating volume, organ perfusion, and pending shock (Paratz et al., 2014; Eastwood et al., 2015). The presence of a urinary catheter however involves the risk of infection.

We read with interest the article by Galiczewski and Shurpin (2017) about the efficiency of direct observation to reduce bladder catheter utilization and catheter-associated urinary tract infections in the ICU.

Read the comment article here

Read the original research article here

Improving the catheter associated UTI rate in an intensive care unit

Galiczewski, J.M. & Shurpin, K.M. Intensive and Critical Care Nursing. Published online: 22 February 2017

Background: Healthcare associated infections from indwelling urinary catheters lead to increased patient morbidity and mortality.

Aim: The purpose of this study was to determine if direct observation of the urinary catheter insertion procedure, as compared to the standard process, decreased catheter utilization and urinary tract infection rates.

Conclusion: The findings from this study may promote changes in clinical practice guidelines leading to a reduction in urinary catheter utilization and infection rates and improved patient outcomes.

Read the full abstract here