The risk of urinary tract infections is increased by unnecessary placement and prolonged use of urinary catheters. We aimed to assess whether inappropriate use of catheters and catheter-associated UTI were reduced through patient participation.
In this multicentre, interrupted time series and before-and-after study, we implemented a patient-centred app which provides catheter advice for patients, together with clinical lessons, feedback via emails and support rounds for staff members. Data on catheter use and infections were collected during a 6-month baseline and a 6-month intervention period on 13 wards in 4 hospitals in the Netherlands. Dutch Trial Register: NL7178.
Between 25 June 2018 and 1 August 2019, 6,556 patients were included in 24 point-prevalence surveys, 3,285(50%) at baseline and 3,271(50%) during the intervention. During the intervention 249 app users and a median of 7 new app users per week were registered (IQR 5.5-13.0). At baseline, inappropriate catheter use was registered for 175 (21.9%) of 798 catheters, compared to 55 (7.0%) of 786 during the intervention. Time series analysis showed a non-significant decrease of inappropriate use of 5.8% (95%CI -3.76 to 15.45, p=0.219), with an odds ratio of 0.27 (0.19 - 0.37, p<0.001). Catheter-associated UTI decreased by 3.0% (1.3 - 4.6, p=0.001), with OR 0.541(0.408-0.716, p<0.001).
Although UTI significantly decreased after the implementation, we found that patient participation did not significantly reduce the prevalence of inappropriate urinary catheter use. However, the inappropriate catheter reduction of 5.8% and an odds ratio of 0.27 suggest a positive trend. Patient participation appears to reduce CAUTI and could reduce other healthcare-associated infections.
Netherlands Organization for Health Research and Development.
The Journal of hospital infection. 2023 Nov 29 [Epub ahead of print]
Robbert G Bentvelsen, Bart J Laan, Tobias Bonten, Rosalie van der Vaart, David J Hetem, Robin Soetekouw, Suzanne Geerlings, Niels H Chavannes, Karin Ellen Veldkamp
Clinical Microbiology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, the Netherlands; Microvida Laboratory for Microbiology, Amphia Hospital Breda, Molengracht 21, 4818 CK Breda, the Netherlands. Electronic address: ., Infectious Diseases, Internal Medicine, Amsterdam UMC, University of Amsterdam. Amsterdam Institute for Infection and Immunity, Infectious diseases. Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands., Public Health and Primary Care, National eHealth Living Lab, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, the Netherlands., Unit of Health, Medical and Neuropsychology, Faculty of Social and Behavioural Sciences, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, the Netherlands., Clinical Microbiology, Haaglanden Medical Centre, the Hague, the Netherlands., Internal Medicine, Spaarne Gasthuis, Haarlem/Hoofddorp, the Netherlands., Clinical Microbiology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, the Netherlands.