Standardisation of perioperative urinary catheter use to reduce postsurgical urinary tract infection: an interrupted time series study

BMJ Quality & Safety
Mahsa SadeghiAvery B Nathens

Abstract

Prevention of healthcare-associated urinary tract infection (UTI) has been the focus of a national effort, yet appropriate indications for insertion and removal of urinary catheters (UC) among surgical patients remain poorly defined. We developed and implemented a standardised approach to perioperative UC use to reduce postsurgical UTI including standard criteria for catheter insertion, training of staff to insert UC using sterile technique and standardised removal in the operating room and surgical unit using a nurse-initiated medical directive. We performed an interrupted time series analysis up to 2 years following intervention. The primary outcome was the proportion of patients who developed postsurgical UTI within 30 days as measured by the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). Process measures included monthly UC insertions, removals in the operating room and UC days per patient-days on surgical units. At baseline, 22.5% of patients were catheterised for surgery, none were removed in the operating room and catheter-days per patient-days were 17.4% on surgical units. Following implementation of intervention, monthly catheter removal in the operating room immediately increas...Continue Reading

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Citations

Jun 21, 2019·Journal of Nursing Care Quality·William MundleLianne Jeffs
Feb 19, 2020·BMJ Quality & Safety·Kaveh G Shojania, Perla J Marang-van de Mheen
Dec 15, 2019·BMJ Quality & Safety·Victoria Williams, Jerome A Leis
May 18, 2020·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Sephalie PatelDaniel A Anaya
Feb 23, 2020·JACC. Clinical Electrophysiology·Asim S AhmedParin J Patel
May 21, 2021·Journal of the American College of Surgeons·Timothy D JacksonAvery Nathens

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