Few interventional studies of catheter-associated urinary tract infection (CAUTI) have been conducted to optimize indwelling urinary catheter (IUC) use in Japan.
The nurse-led, before-after study was conducted at a tertiary care center from June 2018 through May 2022. The intervention included 1) the provision of appropriate indications for IUC use, 2) prospective feedback to the primary care providers by ward nurses on unnecessary/inappropriate IUC use with two, separate interventional phases, the first involving intensive care units (ICU) only, the second involving ICU and general wards, and 3) proactive feedback by Infectious diseases physicians in the Infection Control department to the primary care providers regarding IUC discontinuation upon discharge from the ICU.
During the first phase involving the implementation of the intervention only in the ICU, the indwelling urinary catheter-device utilization ratio (IUC-DUR) trend in the general wards decreased by 1.5 % (P = 0.01). However, the addition of the intervention to the general wards in the second phase led to a 2 % increase in the trend (P = 0.010). The CAUTI incidence in neither the ICU nor the general wards changed significantly.
Although providing feedback on IUC removal at discharge from the ICU and appropriate indications for urinary catheter insertion can reduce inappropriate urinary catheter use, the nurse-led intervention alone was inadequate for reducing the CAUTI incidence.
Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy. 2024 Jul 31 [Epub ahead of print]
Shimpei Harita, Shutaro Murakami, Yasuaki Tagashira, Hitoshi Honda
Teikyo University Graduate School of Public Health, Tokyo, Japan. Electronic address: ., Department of Pharmacy, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan; Department of Public Health and Epidemiology, Meiji Pharmaceutical University, Tokyo, Japan., Department of Infectious Diseases, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan., Department of Infectious Diseases, Fujita Health University School of Medicine, Aichi, Japan. Electronic address: .