-
Comparative Study
Feasibility of audit and feedback to reduce postoperative urinary catheter duration.
- Heidi L Wald and Andrew M Kramer.
- Division of Health Care Policy Research, University of Colorado Denver, School of Medicine, Denver, Colorado, USA. Heidi.Wald@ucdenver.edu
- J Hosp Med. 2011 Apr 1;6(4):183-9.
BackgroundIndwelling urinary catheter duration is an important risk factor for catheter-associated urinary tract infections (CAUTIs).ObjectiveTo audit patient-level postoperative catheter duration and measure the impact of its feedback to nursing staff on postoperative catheter duration and CAUTI rates.DesignPreobservational and postobservational study.SettingTwo surgical units at an urban academic medical center.PatientsPostoperative patients with indwelling urinary catheters.InterventionAudit and feedback of postoperative urinary catheter duration to nurses during an educational session.MeasurementsPatient-level postoperative catheter duration obtained from electronic clinical documentation. Mean catheter duration and proportion of patients with postoperative catheter duration <3 days were determined.ResultsFollowing the intervention, the mean postoperative catheter duration decreased (1.7-1.4 days [P = 0.01] on orthopedic surgery, and 2.6 to 2.2 days [P = 0.01] on general surgery). The proportion of patients with catheter duration <3 days increased significantly on orthopedic surgery (86-92% [P = 0.04]), and nonsignificantly on general surgery (56-63% [P = 0.14]). When adjusted for length of stay differences, the odds of catheter duration <3 days on general surgery increased from 1.38 (P = 0.14) to 1.69 (P = 0.02). The CAUTI rates did not significantly decrease. The rate on orthopedic surgery dropped from 8.9 infections per 1000 device-days to 0 (confidence interval [CI], -1.1 to 18.3); on general surgery the rate was constant at 7 infections per 1000 device-days (CI, -12.1 to 10.8).ConclusionsAudit and feedback of aggregated patient-level urinary catheter duration determined from electronic documentation may prove effective in improving urinary catheter management for surgical patients.Copyright © 2010 Society of Hospital Medicine.
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