Urinary tract infections are the most common type of health care-associated infection, and greater than 75% of them are attributed to an indwelling urinary catheter. A catheter-associated urinary infection may lead to a longer hospital length of stay by as many as 4 days. A new patient care standard requiring twice-daily chlorhexidine cleansing from umbilicus to knees was implemented on all patients of the pilot unit with a urinary catheter. This same technique was used after a patient with a urinary catheter had an incontinent bowel movement. The 9-month average catheter-associated urinary infection rate decreased from 3.06/1000 urinary catheter days to 0.46/1000 urinary catheter days after implementation of the new standard. The use of chlorhexidine for routine urinary catheter care and after bowel movements from umbilicus to knees for patients with urinary catheters may significantly decrease catheter-associated urinary tract infections when compared with the standard of care using soap and water. Standards for Quality Improvement Reporting Excellence guidelines were used in reporting these data.
Dimensions of critical care nursing : DCCN. 0000 Jan [Epub]
Yvonne Schmudde, Kristi Olson-Sitki, Jennifer Bond, Jill Chamberlain
Kristi Olson-Sitki, MSN, RN, NE-BC, is Magnet coordinator at Memorial Medical Center, Springfield, Illinois. Yvonne Schmudde, MS, RN, CCRN, CNE, is nursing outcomes improvement facilitator at Memorial Medical Center, Springfield, Illinois. Jennifer Bond, MS, RN-BC, CCRN-K, is director of Professional Nursing Practice at Memorial Medical Center, Springfield, Illinois. Jill Chamberlain, PhD, RN, CNE, CHSE, is manager of Nursing Research at Memorial Medical Center, Springfield, Illinois.