• Victor Daniel Rosenthal, Sandra Guzman, and Nasia Safdar.
• Department of Infectious Diseases and Hospital Epidemiology, Colegiales Medical Center, Buenos Aires, Argentina.
• Infect Control Hosp Epidemiol. 2004 Jan 1; 25 (1): 47-50.

ObjectiveTo evaluate the effect of education and performance feedback regarding compliance with catheter care and handwashing on rates of catheter-associated urinary tract infection (UTI) in intensive care units (ICUs).SettingTwo level III adult ICUs in a private healthcare facility in Argentina.PatientsAll adult patients admitted to the study units who had a urinary catheter in place for at least 24 hours.MethodsA prospective, open trial in which rates of catheter-associated UTI determined during a baseline period of active surveillance without education and performance feedback were compared with rates of catheter-associated UTI after implementing education and performance feedback.ResultsThere were 1,779 catheter-days during the baseline period and 5,568 catheter-days during the intervention period. Compliance regarding prevention of compression of the tubing by a leg improved (from 83% to 96%; relative risk [RR], 1.15; 95% confidence interval [CI95], 1.03 to 1.28; P = .01) and so did compliance with handwashing (from 23.1% to 65.2%; RR, 2.82; CI95, 2.49 to 3.20; P < .0001). Catheter-associated UTI rates decreased significantly from 21.3 to 12.39 per 1,000 catheter-days (RR, 0.58; CI%, 0.39 to 0.86; P = .006).ConclusionImplementing education and performance feedback regarding catheter care measures and handwashing compliance was associated with a significant reduction in catheter-associated UTI rates. Similar programs may help reduce catheter-associated UTI rates in other Latin American hospitals.

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