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  • Title: Using a criteria-based reminder to reduce use of indwelling urinary catheters and decrease urinary tract infections.
    Author: Chen YY, Chi MM, Chen YC, Chan YJ, Chou SS, Wang FD.
    Journal: Am J Crit Care; 2013 Mar; 22(2):105-14. PubMed ID: 23455860.
    Abstract:
    BACKGROUND: Duration of indwelling urinary catheterization is an important risk factor for urinary tract infection. OBJECTIVES: To determine whether a reminder approach reduces the use of urinary catheters and the incidence of catheter-associated urinary tract infections. METHODS: A randomized control trial was performed in 2 respiratory intensive care units in a 2990-bed tertiary referral medical center. Patients who had urinary catheters in place for more than 2 days from April through November 2008 were randomly assigned to either the intervention group (use of a criteria-based reminder to remove the catheter) or the control group (no reminder). RESULTS: A total of 278 patients were recruited. Utilization rate of indwelling urinary catheters was decreased by 22% in the intervention group compared with the control group (relative risk, 0.78; 95% CI, 0.76-0.80; P < .001). The intervention significantly shortened the median duration of catheterization (7 days vs 11 days for the control group; P < .001). The success rate for removing the catheters in the intervention group by day 7 was 88%. The reminder intervention reduced the incidence of catheter-associated infections by 48% (relative risk, 0.52; 95% CI, 0.32-0.86; P = .009) in the intervention group compared with the control group. CONCLUSIONS: Use of a criteria-based reminder to remove indwelling urinary catheters can diminish the use of urinary catheterization and reduce the likelihood of catheter-associated urinary infections. This reminder approach can prevent catheter-associated urinary infections, and its use should be strongly considered as a way to enhance the safety of patients.
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