• Areta Kowal-Vem, Stathis Poulakidas, Barbara Barnett, Deborah Conway, Daniel Culver, Michelle Ferrari, Bruce Potenza, Michael Koenig, John Mah, Mary Majewski, Linda Morris, Jan Powers, Elizabeth Stokes, Michael Tan, Sara-Jane Salstrom, Cindy Zaletel, Shirley Ambutas, Kathleen Casey, Jayne Stein, Mary DeSane, Kathy Berry, Elizabeth C Konz, Michael R Riemer, and Malford E Cullum.
• John H. Stroger Hospital, Cook County, Chicago, Illinois, USA.
• Am. J. Crit. Care. 2009 May 1; 18 (3 Suppl): S2-14: quiz S15.

BackgroundFecal contamination is a major challenge in patients in acute/critical care settings that is associated with increased cost of care and supplies and with development of pressure ulcers, incontinence dermatitis, skin and soft tissue infections, and urinary tract infections.ObjectivesTo assess the economic impact of fecal containment in bedridden patients using 2 different indwelling bowel catheters and to compare infection rates between groups.MethodsA multicenter, observational study was done at 12 US sites (7 that use catheter A, 5 that use catheter B). Patients were followed from insertion of an indwelling bowel catheter system until the patient left the acute/critical care unit or until 29 days after enrollment, whichever came first. Demographic data, frequency of bedding/dressing changes, incidence of infection, and Braden scores (risk of pressure ulcers) were recorded.ResultsThe study included 146 bedridden patients (76 with catheter A, 70 with catheter B) who had similar Braden scores at enrollment. The rate of bedding/dressing changes per day differed significantly between groups (1.20 for catheter A vs 1.71 for catheter B; P = .004). According to a formula that accounted for personnel resources and laundry cycle costs, catheter A cost $13.94 less per patient per day to use than did catheter B. Catheter A was less likely than was catheter B to be removed during the observational period (P = .03). Observed infection rates were low.ConclusionCatheter A may be more cost-effective than catheter B because it requires fewer unscheduled linen changes per patient day.

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