PURPOSE: Indwelling urinary catheters commonly used in the care of critically ill patient's in the intensive care units(ICU), are responsible for the commonest nosocomial infection. These Catheter related Urinary tract Infections (UTI's) increase morbidity, mortality and increases health care costs. There is a paucity of data on best practices to decrease the incidence of Catheter related UTI's and “Urinary catheter bundle does not exist.” The objective was to decrease Catheter related bloodstream infection among adult patients hospitalized in ICU in an urban inner city hospital. Before the study period in 2005, the incidence of Catheter UTI's was 12/1000 catheter days.
METHODS: The analysis included all patients hospitalized in Medical Intensive Care Unit from January 2004 until December 2006 and who had a urinary catheter inserted during hospitalization. In an effort to decrease the incidence of catheter related UTI's several interventions were made and included using anti-infective urinary catheters, new closed drainage system and daily evaluation for catheter removal. Catheter related UTI's and device days were collected by Infection control as per CDC guidelines.
RESULTS: A total of 8221 Device days and 22 catheter related UTI's were collected during three years period. Results of our study showed that after interventions the rate of Catheter related UTI's decreased from an incidence of 6.24/ 1000 device days in 2004 (baseline) to an incidence of 0.72/1000 device days in 2005 and was maintained at 0.77/1000 device days in 2006. The device utilization rate for 2006 was between 25 to 50 percentile indicating a deceased usage of the device. The device days steadily decreased despite an increase in admissions. There were no Catheter related UTI for a consecutive period of 300 days in 2005 and 270 days in 2006.
CONCLUSION: An evidence-based intervention resulted in 88 percent reduction in incidence rates of Catheter related UTI's that was maintained throughout the two years period after the interventions.
CLINICAL IMPLICATIONS: UTI's can be significantly reduced by the implementation of simple practices with resulting decreased morbidity and mortality.
DISCLOSURE: Sindhaghatta Venkatram, No Financial Disclosure Information; No Product/Research Disclosure Information