What are three steps you can take to decrease the risk of infection for your client during catheter care?

Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review

1. Jennifer Meddings1,
2. Mary A M Rogers1,
3. Sarah L Krein1,2,
4. Mohamad G Fakih3,
5. Russell N Olmsted4,
6. Sanjay Saint2,1

1. 1Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
2. 2VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
3. 3Department of Internal Medicine, St. John Hospital and Medical Center, Detroit, Michigan, USA
4. 4St. Joseph Mercy Health System, Ann Arbor, Michigan, USA

1. Correspondence to Dr Jennifer Meddings, Department of Internal Medicine, University of Michigan Medical School, 2800 Plymouth Road, Building 16, Room 427W, Ann Arbor, MI 48109, USA; Meddings{at}umich.edu

Abstract

Background Catheter-associated urinary tract infections [CAUTI] are costly, common and often preventable by reducing unnecessary urinary catheter [UC] use.

Methods To summarise interventions to reduce UC use and CAUTIs, we updated a prior systematic review [through October 2012], and a meta-analysis regarding interventions prompting UC removal by reminders or stop orders. A narrative review summarises other CAUTI prevention strategies including aseptic insertion, catheter maintenance, antimicrobial UCs, and bladder bundle implementation.

Results 30 studies were identified and summarised with interventions to prompt removal of UCs, with potential for inclusion in the meta-analyses. By meta-analysis [11 studies], the rate of CAUTI [episodes per 1000 catheter-days] was reduced by 53% [rate ratio 0.47; 95% CI 0.30 to 0.64, p