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Effect of Education and Performance Feedback on Rates of Catheter-Associated Urinary Tract Infection in Intensive Care Units in Argentina

Published online by Cambridge University Press:  02 January 2015

Victor Daniel Rosenthal ,
Sandra Guzman  and
Nasia Safdar
Victor Daniel Rosenthal*
Affiliation:
Department of Infectious Diseases and Hospital Epidemiology, Colegiales Medical Center, Buenos Aires, Argentina
Sandra Guzman
Affiliation:
Department of Infectious Diseases and Hospital Epidemiology, Colegiales Medical Center, Buenos Aires, Argentina
Nasia Safdar
Affiliation:
Section of Infectious Diseases, Department of Medicine, University of Wisconsin Medical School, Madison, Wisconsin
*
Arengreen 1366, Buenos Aires, Argentina 1405
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Abstract

Objective:

To evaluate the effect of education and performance feedback regarding compliance with catheter care and handwashing on rates of catheter-associated urinary tract infection (UTI) in intensive care units (ICUs).

Setting:

Two level III adult ICUs in a private healthcare facility in Argentina.

Patients:

All adult patients admitted to the study units who had a urinary catheter in place for at least 24 hours.

Methods:

A prospective, open trial in which rates of catheter-associated UTI determined during a baseline period of active surveillance without education and performance feedback were compared with rates of catheter-associated UTI after imple-menting education and performance feedback.

Results:

There were 1,779 catheter-days during the baseline period and 5,568 catheter-days during the intervention period. Compliance regarding prevention of compression of the tubing by a leg improved (from 83% to 96%; relative risk [RR], 1.15; 95% confidence interval [CI95], 1.03 to 1.28; P = .01) and so did compliance with handwashing (from 23.1% to 65.2%; RR, 2.82; CI95, 2.49 to 3.20; P<.0001). Catheter-associated UTI rates decreased significantly from 21.3 to 12.39 per 1,000 catheter-days (RR, 0.58; CI95, 0.39 to 0.86; P = .006).

Conclusion:

Implementing education and performance feedback regarding catheter care measures and handwashing compliance was associated with a significant reduction in catheter-associated UTI rates. Similar programs may help reduce catheter-associated UTI rates in other Latin American hospitals.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 1 , January 2004 , pp. 47 - 50
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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References

1.Maki, DG, Tambyah, PA. Engineering out the risk for infection with urinary catheters. Emerg Infect Dis 2001;7:342–347.Google Scholar
2.Warren, JW. Catheter-associated urinary tract infection. Infect Dis Clin North Am 1997;11:609–622.CrossRefGoogle Scholar
3.Tambyah, PA, Maki, DGC. Catheter-associated urinary tract infection is rarely symptomatic: a prospective study of 1497 catheterized patients. Arch Intern Med 2000;160:678–682.CrossRefGoogle Scholar
4.Centers for Disease Control and Prevention. National Nosocomial Infections Surveillance (NNIS) System report: data summary from January 1992-April 2000, issued June 2000. Am J Infect Control 2000;28:429–448.Google Scholar
5.Tambyah, PA, Knasinski, V, Maki, DG. The direct costs of nosocomial catheter-associated urinary tract infection in the era of managed care. Infect Control Hosp Epidemiol 2002;23:27–31.CrossRefGoogle ScholarPubMed
6.Platt, R, Polk, BF, Murdock, B, Rosner, B. Reduction of mortality associated with nosocomial urinary tract infection. Lancet 1983,1:893–897.Google Scholar
7.Rosenthal, VD, Guzman, S, Migone, O. Exceso de costos debido a infecciones nosocomiales en dos unidades de cuidados intensivos de un hospital privado de Argentina. Rev Panant Salud Publica. In press.Google Scholar
8.Burke, JP, Larsen, RA, Stevens, LE. Nosocomial bacteriuria: estimating the potential for prevention by closed sterile urinary drainage. Infect Control 1986;7:96–99.Google ScholarPubMed
9.Maki, DG, Knasinski, V, Halvorson, K, Tambyah, PA. A novel silver hydrogel-impregnated indwelling urinary catheter reduces CAUTIs: a prospective double blind trial. Infect Control Hosp Epidemiol 1998;19:682.Google Scholar
10.Gaynes, RP, Culver, DH, Emori, TG, et al.The National Nosocomial Infections Surveillance System: plans for the 1990s and beyond. Am J Med 1991;91:116S–120S.CrossRefGoogle ScholarPubMed
11.Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988;16:128–140.CrossRefGoogle ScholarPubMed
12.Balows, LE, Hausler, W, Shadomy, H. Manual of Clinical Microbiology. Washington, DC: American Society for Microbiology; 1991.Google Scholar
13.Wong, ES. Guideline for prevention of catheter-associated urinary tract infections. Am J Infect Control 1983;11:28–36.Google Scholar
14.Boyce, JM, Pittet, D. Guideline for hand hygiene in health-care settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. MMWR 2002:51:145.Google ScholarPubMed
15.Goetz, AM, Kedzuf, S, Wagener, M, Muder, RR. Feedback to nursing staff as an intervention to reduce catheter-associated urinary tract infections. Am J Infect Control 1999;27:402–404.CrossRefGoogle ScholarPubMed
16.Rosenthal, VD, McCormick, RD, Guzman, S, Villamayor, C, Orellano, PW. Effect of education and performance feedback on handwashing: the benefit of administrative support in Argentinean hospitals. Am J Infect Control 2003;31:85–92.Google Scholar
17.Rosenthal, VD, Guzman, S, Pezzotto, SM, Crnich, CJ. Effect of an infection control program using education and performance feedback on rates of intravascular device-associated bloodstream infections in intensive care units in Argentina. Am J Infect Control 2003;31:405–409.Google Scholar
18.Britt, MR, Schleupner, CJ, Matsumiya, S. Severity of underlying disease as a predictor of nosocomial infection: utility in the control of nosocomial infection. JAMA 1978;239:1047–1051.CrossRefGoogle ScholarPubMed