Indwelling urinary catheters are commonly used in hospitalized patients, which can lead to the development of urinary catheter complications, including catheter-associated urinary tract infection (CAUTI). Limited reports on the appropriateness of urinary catheter use exist in Japan. This study investigated the prevalence and appropriateness of indwelling urinary catheters, and the incidence of CAUTI in non-intensive care unit (non-ICU) wards in Japanese hospitals.
This prospective observational study was conducted in 7 non-ICU wards from 6 hospitals in Japan from October 2017 to June 2018. At each hospital the study teams evaluated urinary catheter prevalence through in-person bedside evaluation for at least 5 days of each week for 3 months. Catheter associated urinary tract infection (CAUTI) incidence and appropriateness of catheter use was collected via chart review.
We assessed 710 catheter-days over 5528 patient-days. The mean prevalence of indwelling urinary catheter use in participating wards was 13% (range: 5% to 19%), while the mean incidence of CAUTI was 9.86 per 1000 catheter-days (range: 0 to 33.90). Approximately 66% of the urinary catheter days assessed had an appropriate indication for use (range: 17% to 81%). A physician's order for catheter placement was present in only 10% of catheterized patients.
This multicenter study provides epidemiological information about the appropriate use of urinary catheters in Japanese non-ICU wards. A multimodal intervention may help improve the appropriate use of urinary catheters.
BMC infectious diseases. 2022 Feb 21*** epublish ***
Kohta Katayama, Jennifer Meddings, Sanjay Saint, Karen E Fowler, David Ratz, Yasuaki Tagashira, Yumi Kawamura, Tatsuya Fujikawa, Sho Nishiguchi, Naomi Kayauchi, Nobumasa Takagaki, Yasuharu Tokuda, Akira Kuriyama
Department of General Medicine, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita, Chiba, 286-8520, Japan. ., Center for Clinical Management Research, U.S. Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA., Division of Infectious Diseases, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan., Department of General Internal Medicine and Emergency Medicine, Mimihara General Hospital, Sakai, Osaka, Japan., Department of General Internal Medicine, Mitoyo General Hospital, Kanonji, Kagawa, Japan., Department of General Internal Medicine, Shonan Kamakura General Hospital, Kamakura, Japan., Department of Infection Control, Mito Kyodo General Hospital, Mito, Ibaraki, Japan., Nobumasa Clinic, Kyoto, Japan., Muribushi Okinawa Center for Teaching Hospitals, Urasoe, Okinawa, Japan., Emergency and Critical Care Center, Kurashiki Central Hospital, Kurashiki, Okayama, Japan.