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Published by: The University of Chicago Press on behalf of The Society for Healthcare Epidemiology of America
Article DOI: 10.1086/502329
Stable URL: http://www.jstor.org/stable/10.1086/502329
Catheter‐Associated Urinary Tract Infections in Intensive Care Units Can Be Reduced by Prompting Physicians to Remove Unnecessary Catheters • 
Wei‐Chun Huang , MD, Shue‐Ren Wann , MD, Shoa‐Lin Lin , MD, Calvin M. Kunin , MD, Ming‐Ho Kung , MD, Chin‐Hsun Lin , MD, Chien‐Wei Hsu , MD, Chun‐Peng Liu , MD, Susan Shin‐Jung Lee , MD, Yung‐Ching Liu , MD, Kwok‐Hung Lai , MD and Tzu‐Wen Lin
Infection Control and Hospital Epidemiology , Vol. 25, No. 11 (November 2004), pp. 974-978
Published by: The University of Chicago Press on behalf of The Society for Healthcare Epidemiology of America
Article DOI: 10.1086/502329
Article Stable URL: http://www.jstor.org/stable/10.1086/502329
Original Articles

Catheter‐Associated Urinary Tract Infections in Intensive Care Units Can Be Reduced by Prompting Physicians to Remove Unnecessary Catheters

Formats Available in JSTOR: PDF

Abstract(back to top)

OBJECTIVE. Indwelling urinary catheters are the most common source of infections in intensive care units (ICUs). The aim of this study was to evaluate the efficacy of nurse‐generated daily reminders to physicians to remove unnecessary urinary catheters 5 days after insertion.

DESIGN. A time‐sequence nonrandomized intervention study.

SETTING. Adult ICUs (medical, surgical, cardiovascular surgical, neurosurgical, and coronary care) of a tertiary‐care university medical center.

PATIENTS. All patients admitted to the adult ICUs during a 2‐year period. The study consisted of a 12‐month observational phase (15,960 patient‐days) followed by a 12‐month intervention phase (15,525 patient‐days).

INTERVENTION. Daily reminders to physicians from the nursing staff to remove unnecessary urinary catheters 5 days after insertion.

RESULTS. The duration of urinary catheterization was significantly reduced during the intervention phase (from 7.0 � 1.1 days to 4.6 � 0.7 days; P < .001). The rate of catheter‐associated urinary tract infection (CAUTI) was also significantly reduced (from 11.5 � 3.1 to 8.3 � 2.5 patients with CAUTI per 1,000 catheter‐days; P = .009). There was a linear relationship between the monthly average duration of catheterization and the rate of CAUTI (r = 0.50; P = .01). The excess monthly cost of antibiotics for CAUTI was reduced by 69% (from $4,021 � $1,800 to $1,220 � $941; P = .004).

CONCLUSION. This study demonstrated that a simple measure instituted as part of a continuous quality improvement program significantly reduced the duration of urinary catheterization, rate of CAUTI, and additional costs of antibiotics to manage CAUTI.

Bibliographic Information(back to top)

  • Catheter‐Associated Urinary Tract Infections in Intensive Care Units Can Be Reduced by Prompting Physicians to Remove Unnecessary Catheters
  • Wei‐Chun Huang , MD, Shue‐Ren Wann , MD, Shoa‐Lin Lin , MD, Calvin M. Kunin , MD, Ming‐Ho Kung , MD, Chin‐Hsun Lin , MD, Chien‐Wei Hsu , MD, Chun‐Peng Liu , MD, Susan Shin‐Jung Lee , MD, Yung‐Ching Liu , MD, Kwok‐Hung Lai , MD and Tzu‐Wen Lin
  • Infection Control and Hospital Epidemiology
  • Vol. 25, No. 11 (November 2004) (pp. 974-978)

Author Information(back to top)

Wei‐Chun Huang , MD; Shue‐Ren Wann , MD; Shoa‐Lin Lin , MD; Calvin M. Kunin , MD; Ming‐Ho Kung , MD; Chin‐Hsun Lin , MD; Chien‐Wei Hsu , MD; Chun‐Peng Liu , MD; Susan Shin‐Jung Lee , MD; Yung‐Ching Liu , MD; Kwok‐Hung Lai , MD; Tzu‐Wen Lin , MD

Notes and References(back to top)

This item contains 1 note(s).

Notes

Drs. Huang, Wann, S‐L. Lin, Kung, C‐H. Lin, and Hsu are from the Intensive Care Unit and Drs. Wann, Lee, and Y‐C. Liu are from the Section of Infectious Diseases and Microbiology, Kaohsiung. Veterans General Hospital, Kaohsiung, China. Drs. S‐L. Lin, C‐P. Liu, and Lai are from the National Yang‐Ming University, School of Medicine, Taipei, Taiwan, Republic of China. Dr. Kunin is from the Ohio State University College of Medicine and Public Health, Columbus, Ohio. Mr. Lin is from the Chengshiu Institute of Technology, Kaohsiung, Taiwan, Republic of China.Address reprint requests to Shoa‐Lin Lin, MD, Intensive Care Unit, Kaohsiung Veterans General Hospital, No. 386, Dar‐Chung First Road, Kaohsiung, Taiwan, Republic of China.Supported by the Kaohsiung Veterans General Hospital, grant no. VGHKS 91‐41.The authors thank Ru‐Yuh Wen, SV, Chung‐Hsiu Wei, HN, Hung‐Ling Chen, AHN, Hsing‐Chi Ching, RN, Hsueh‐Lan Chao, RN, and Pi‐Lai Tseng, RPh, for their clinical assistance; and Kuei‐Fang Su and Tzu‐Yin Kuo for their secretarial work.

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