Cargando…
Avoiding inappropriate urinary catheter use and catheter-associated urinary tract infection (CAUTI): a pre-post control intervention study
BACKGROUND: Urinary tract infection (UTI) as the most common healthcare-associated infection accounts for up to 36% of all healthcare-associated infections. Catheter-associated urinary tract infection (CAUTI) accounts for up to 80% of these. In many instances indwelling urinary catheter (IDC) insert...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5414128/ https://www.ncbi.nlm.nih.gov/pubmed/28464815 http://dx.doi.org/10.1186/s12913-017-2268-2 |
_version_ | 1783233301133131776 |
---|---|
author | Parker, Vicki Giles, Michelle Graham, Laura Suthers, Belinda Watts, Wendy O’Brien, Tony Searles, Andrew |
author_facet | Parker, Vicki Giles, Michelle Graham, Laura Suthers, Belinda Watts, Wendy O’Brien, Tony Searles, Andrew |
author_sort | Parker, Vicki |
collection | PubMed |
description | BACKGROUND: Urinary tract infection (UTI) as the most common healthcare-associated infection accounts for up to 36% of all healthcare-associated infections. Catheter-associated urinary tract infection (CAUTI) accounts for up to 80% of these. In many instances indwelling urinary catheter (IDC) insertions may be unjustified or inappropriate, creating potentially avoidable and significant patient distress, embarrassment, discomfort, pain and activity restrictions, together with substantial care burden, costs and hospitalisation. Multifaceted interventions combining best practice guidelines with staff engagement, education and monitoring have been shown to be more effective in bringing about practice change than those that focus on a single intervention. This study builds on a nurse-led initiative that identified that significant benefits could be achieved through a systematic approach to implementation of evidence-based practice. METHODS: The primary aim of the study is to reduce IDC usage rates by reducing inappropriate urinary catheterisation and duration of catheterisation. The study will employ a multiple pre-post control intervention design using a phased mixed method approach. A multifaceted intervention will be implemented and evaluated in four acute care hospitals in NSW, Australia. The study design is novel and strengthened by a phased approach across sites which allows for a built-in control mechanism and also reduces secular effects. Feedback of point prevalence data will be utilised to engage staff and improve compliance. Ward-based champions will help to steward the change and maintain focus. DISCUSSION: This study will improve patient safety through implementation and robust evaluation of clinical practice and practice change. It is anticipated that it will contribute to a significant improvement in patient experiences and health care outcomes. The provision of baseline data will provide a platform from which to ensure ongoing improvement and normalisation of best practice. This study will add to the evidence base through enhancing understanding of interventions to reduce CAUTI and provides a prototype for other studies focussed on reduction of hospital acquired harms. Study findings will inform undergraduate and continuing education for health professionals. TRIAL REGISTRATION: ACTRN12617000090314. Registered 17 January 2017. Retrospectively registered. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-017-2268-2) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5414128 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-54141282017-05-03 Avoiding inappropriate urinary catheter use and catheter-associated urinary tract infection (CAUTI): a pre-post control intervention study Parker, Vicki Giles, Michelle Graham, Laura Suthers, Belinda Watts, Wendy O’Brien, Tony Searles, Andrew BMC Health Serv Res Study Protocol BACKGROUND: Urinary tract infection (UTI) as the most common healthcare-associated infection accounts for up to 36% of all healthcare-associated infections. Catheter-associated urinary tract infection (CAUTI) accounts for up to 80% of these. In many instances indwelling urinary catheter (IDC) insertions may be unjustified or inappropriate, creating potentially avoidable and significant patient distress, embarrassment, discomfort, pain and activity restrictions, together with substantial care burden, costs and hospitalisation. Multifaceted interventions combining best practice guidelines with staff engagement, education and monitoring have been shown to be more effective in bringing about practice change than those that focus on a single intervention. This study builds on a nurse-led initiative that identified that significant benefits could be achieved through a systematic approach to implementation of evidence-based practice. METHODS: The primary aim of the study is to reduce IDC usage rates by reducing inappropriate urinary catheterisation and duration of catheterisation. The study will employ a multiple pre-post control intervention design using a phased mixed method approach. A multifaceted intervention will be implemented and evaluated in four acute care hospitals in NSW, Australia. The study design is novel and strengthened by a phased approach across sites which allows for a built-in control mechanism and also reduces secular effects. Feedback of point prevalence data will be utilised to engage staff and improve compliance. Ward-based champions will help to steward the change and maintain focus. DISCUSSION: This study will improve patient safety through implementation and robust evaluation of clinical practice and practice change. It is anticipated that it will contribute to a significant improvement in patient experiences and health care outcomes. The provision of baseline data will provide a platform from which to ensure ongoing improvement and normalisation of best practice. This study will add to the evidence base through enhancing understanding of interventions to reduce CAUTI and provides a prototype for other studies focussed on reduction of hospital acquired harms. Study findings will inform undergraduate and continuing education for health professionals. TRIAL REGISTRATION: ACTRN12617000090314. Registered 17 January 2017. Retrospectively registered. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-017-2268-2) contains supplementary material, which is available to authorized users. BioMed Central 2017-05-02 /pmc/articles/PMC5414128/ /pubmed/28464815 http://dx.doi.org/10.1186/s12913-017-2268-2 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Study Protocol Parker, Vicki Giles, Michelle Graham, Laura Suthers, Belinda Watts, Wendy O’Brien, Tony Searles, Andrew Avoiding inappropriate urinary catheter use and catheter-associated urinary tract infection (CAUTI): a pre-post control intervention study |
title | Avoiding inappropriate urinary catheter use and catheter-associated urinary tract infection (CAUTI): a pre-post control intervention study |
title_full | Avoiding inappropriate urinary catheter use and catheter-associated urinary tract infection (CAUTI): a pre-post control intervention study |
title_fullStr | Avoiding inappropriate urinary catheter use and catheter-associated urinary tract infection (CAUTI): a pre-post control intervention study |
title_full_unstemmed | Avoiding inappropriate urinary catheter use and catheter-associated urinary tract infection (CAUTI): a pre-post control intervention study |
title_short | Avoiding inappropriate urinary catheter use and catheter-associated urinary tract infection (CAUTI): a pre-post control intervention study |
title_sort | avoiding inappropriate urinary catheter use and catheter-associated urinary tract infection (cauti): a pre-post control intervention study |
topic | Study Protocol |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5414128/ https://www.ncbi.nlm.nih.gov/pubmed/28464815 http://dx.doi.org/10.1186/s12913-017-2268-2 |
work_keys_str_mv | AT parkervicki avoidinginappropriateurinarycatheteruseandcatheterassociatedurinarytractinfectioncautiaprepostcontrolinterventionstudy AT gilesmichelle avoidinginappropriateurinarycatheteruseandcatheterassociatedurinarytractinfectioncautiaprepostcontrolinterventionstudy AT grahamlaura avoidinginappropriateurinarycatheteruseandcatheterassociatedurinarytractinfectioncautiaprepostcontrolinterventionstudy AT suthersbelinda avoidinginappropriateurinarycatheteruseandcatheterassociatedurinarytractinfectioncautiaprepostcontrolinterventionstudy AT wattswendy avoidinginappropriateurinarycatheteruseandcatheterassociatedurinarytractinfectioncautiaprepostcontrolinterventionstudy AT obrientony avoidinginappropriateurinarycatheteruseandcatheterassociatedurinarytractinfectioncautiaprepostcontrolinterventionstudy AT searlesandrew avoidinginappropriateurinarycatheteruseandcatheterassociatedurinarytractinfectioncautiaprepostcontrolinterventionstudy |