Determinants of urinary catheter removal practices in the pediatric intensive care unit: A survey

Prolonged use of indwelling catheters is associated with hospital-acquired urinary tract infections (UTIs). Literature is scarce about the factors influencing urinary catheter removal and maintenance in children. This study aims to describe the determinants of urinary catheter removal in pediatric intensive care unit (PICU) patients.

Cross-sectional survey of 171 physicians and nurses working at 2 tertiary PICUs in Montreal, Canada. We used focus groups and literature review to design the survey questions and 3 clinical scenarios. We analyzed our results using descriptive statistics and multivariate multinomial regression.

There were 131 (77%) participants who answered the survey. Factors prompting urinary catheter removal (P < .01) included recent extubation, superficial sedation level, fever, and history of previous UTI. Presence of shock (P < .01) and fluid overload (P < .05) were associated with maintenance of catheters. Physicians were more likely to remove urinary catheters than nurses in all scenarios.

We identified a consistent set of variables that drive the removal of indwelling catheters in PICUs. Studies are needed to determine whether incorporating these determinants into infection control interventions will reduce urinary catheter use and catheter-associated UTIs in critically ill children.

American journal of infection control. 2018 Mar 05 [Epub ahead of print]

Karen Trudel, Samara Zavalkoff, Nicholas Winters, Caroline Quach, Jacques Lacroix, Patricia S Fontela

London School of Tropical Medicine, University of London, London, UK., Division of Pediatric Critical Care, Department of Pediatrics, McGill University, Montreal, QC, Canada., The Research Institute of the McGill University Health Center, Montreal, QC, Canada., The Research Institute of the McGill University Health Center, Montreal, QC, Canada; Department of Microbiology, Infectious Disease and Immunology, Université de Montréal, Montreal, QC, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada., Division of Pediatric Critical Care, Department of Pediatrics, Université de Montréal, Montreal, QC, Canada., Division of Pediatric Critical Care, Department of Pediatrics, McGill University, Montreal, QC, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada. Electronic address: .

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