Control catheter-associated urinary tract infections in a neurosurgery intensive care unit

The prolonged use of indwelling urinary catheters can lead to many complications, the most prevalent being urinary tract infections. These hospital-acquired infections can increase hospital costs, length of stay, and mortality rates. Evidence-based guidelines for the prevention of urinary tract infections are compared and discussed. Minimizing indwelling urinary catheter use is well-recognized in the literature to reduce the risk of these infections. To decrease the incidence of catheter-associated urinary tract infections, the staff of a 22-bed, mixed medical, surgical, and trauma intensive care unit focused on reducing the number of foley catheter device days. A multidisciplinary team was convened to create an evidence-based plan. Staff nurses were engaged in the development and implementation of the plan. Criteria-based foley catheter guidelines, a decision-making algorithm, and a daily checklist were implemented that led to a significant reduction in foley catheter device days and a decrease in catheter-associated urinary tract infections.

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Chasing Zero Catheter Associated Urinary Tract Infections (CAUTIs) through Implementing a Novel Female External Urine Collection Device in a Tertiary Academic Surgical Intensive Care Unit (SICU)

American Journal of Infection Control ◽

10.1016/j.ajic.2018.04.027 ◽

2018 ◽

Vol 46 (6) ◽

pp. S14 ◽

Cited By ~ 2

Author(s):

Terrie Beeson ◽

Carmen Davis ◽

Kathleen M. Vollman

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Surgical Intensive Care Unit ◽

Urine Collection ◽

Surgical Intensive Care ◽

Collection Device ◽

Tract Infections

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Reducing Use of Indwelling Urinary Catheters and Associated Urinary Tract Infections

American Journal of Critical Care ◽

10.4037/ajcc2009938 ◽

2009 ◽

Vol 18 (6) ◽

pp. 535-541 ◽

Cited By ~ 55

Author(s):

Ellen H. Elpern ◽

Kathryn Killeen ◽

Alice Ketchem ◽

Amanda Wiley ◽

Gourang Patel ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Medical Intensive Care Unit ◽

Urinary Catheterization ◽

Intervention Period ◽

Urinary Catheters ◽

Medical Intensive Care ◽

Tract Infections

Background Use of indwelling urinary catheters can lead to complications, most commonly catheter-associated urinary tract infections. Duration of catheterization is the major risk factor. These infections can result in sepsis, prolonged hospitalization, additional hospital costs, and mortality. Objectives To implement and evaluate the efficacy of an intervention to reduce catheter-associated urinary tract infections in a medical intensive care unit by decreasing use of urinary catheters. Methods Indications for continuing urinary catheterization with indwelling devices were developed by unit clinicians. For a 6-month intervention period, patients in a medical intensive care unit who had indwelling urinary catheters were evaluated daily by using criteria for appropriate catheter continuance. Recommendations were made to discontinue indwelling urinary catheters in patients who did not meet the criteria. Days of use of a urinary catheter and rates of catheter-associated urinary tract infections during the intervention were compared with those of the preceding 11 months. Results During the study period, 337 patients had a total of 1432 days of urinary catheterization. With use of guidelines, duration of use was significantly reduced to a mean of 238.6 d/mo from the previous rate of 311.7 d/mo. The number of catheter-associated urinary tract infections per 1000 days of use was a mean of 4.7/mo before the intervention and zero during the 6-month intervention period. Conclusions Implementation of an intervention to judge appropriateness of indwelling urinary catheters may result in significant reductions in duration of catheterization and occurrences of catheter-associated urinary tract infections.

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Incidence of nosocomial urinary tract infections on a surgical intensive care unit and implications for management

International Journal of Antimicrobial Agents ◽

10.1016/j.ijantimicag.2006.05.011 ◽

2006 ◽

Vol 28 ◽

pp. 86-90 ◽

Cited By ~ 27

Author(s):

F.M.E. Wagenlehner ◽

E. Loibl ◽

H. Vogel ◽

K.G. Naber

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Surgical Intensive Care Unit ◽

Surgical Intensive Care ◽

Tract Infections

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Recognition and prevention of healthcare-associated urinary tract infections in the intensive care unit

Critical Care Medicine ◽

10.1097/ccm.0b013e3181e6ce8f ◽

2010 ◽

Vol 38 ◽

pp. S373-S379 ◽

Cited By ~ 47

Author(s):

Emily K. Shuman ◽

Carol E. Chenoweth

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Tract Infections ◽

Healthcare Associated

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Decreasing Catheter-Associated Urinary Tract Infections in the Neurological Intensive Care Unit: One Unit’s Success

Critical Care Nurse ◽

10.4037/ccn2017742 ◽

2017 ◽

Vol 37 (3) ◽

pp. 42-48 ◽

Cited By ~ 9

Author(s):

Brenda Richards ◽

Bindhu Sebastian ◽

Hillary Sullivan ◽

Rosemarie Reyes ◽

John F. D’Agostino ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Current Evidence ◽

Evidence Based ◽

Neurological Intensive Care Unit ◽

Evidence Based Practices ◽

Neurological Intensive Care ◽

Tract Infections

BACKGROUND Catheter-associated urinary tract infections are preventable adverse outcomes that increase hospital morbidity, mortality, and costs. These infections are particularly prevalent in intensive care units. OBJECTIVES To describe the success of an 18-bed neurological intensive care unit in using several nurse-implemented strategies that reduced the number of catheter-associated urinary tract infections. METHODS A prospective, interventional design with application of evidence-based practices to reduce catheter-associated urinary tract infections was used. RESULTS Before implementation of the strategies, 40 catheter-associated urinary tract infections were reported for 2012 and 38 for 2013. The standardized infection ratio was 2.04 for 2012 (95% CI, 1.456–2.775) and 2.34 (95% CI, 1.522–3.312) for 2013. After implementation of the strategies, significantly fewer catheter-associated urinary tract infections were reported. In 2014, a total of 15 infections were reported, and the standardized infection ratio was less than 1.0 (95% CI, 0.685–1.900). CONCLUSIONS Application of current evidence-based practices resulted in a substantial decrease in the number of catheter-associated urinary tract infections and a lower standardized infection ratio. These findings support current recommendations for “bundling” to maximize outcomes.

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Geriatric urinary tract infections: The value of laboratory parameters in estimating the need for bacteremia and Intensive Care Unit

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.1.97 ◽

2018 ◽

Vol 35 (1) ◽

Author(s):

Ayse Sagmak Tartar ◽

Safak Ozer Balin

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Direct Bilirubin ◽

Distribution Width ◽

Laboratory Parameters ◽

Neutrophil Lymphocyte Ratio ◽

Laboratory Values ◽

Tract Infections

Objective: We investigated the geriatric patients diagnosed as urinary tract infection and evaluated the effects of white blood cell (WBC), neutrophil count, platelet, mean platelet volume (MPV), red cell distribution width (RDW), total bilirubin, direct bilirubin, creatine, albumin, erythrocyte sedimentation rate, C-reactive protein, and neutrophil/lymphocyte ratio parameters on estimating the need for bacteremia and intensive care (IC) for the patients with pyelonephritis Methods: Between 2016-2017, a total number of 188 patients aged 65 years and above were retrospectively evaluated at the infectious diseases clinic. Results: The 124 (66%) of the patients were male and 64 (34%) were female. The laboratory values of the patients with pyelonephritis and urosepsis were found to be significantly lower in only RDW bacteremic patients (p=0.047). The laboratory values during the application of third-step IC unit patients, who were treated and discharged, were compared. Albumin was significantly lower, while direct bilirubin, AST and ALT were significantly higher (p<0.05). Conclusions: Patients, whose biochemical parameters have changed, especially during admission or follow-up, should be evaluated carefully in terms of urosepsis, multiple organ failure and IC need. A number of diagnostic tests have been described to predict the need for sepsis and IC. However, many of them cannot be performed in emergency conditions. It is a great advantage that the parameters we use in our work are easily accessible and can be performed in emergency conditions. How to cite this:Tartar AS, Balin SO. Geriatric urinary tract infections: The value of laboratory parameters in estimating the need for bacteremia and Intensive Care Unit. Pak J Med Sci. 2019;35(1):---------. doi: https://doi.org/10.12669/pjms.35.1.97 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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