Effect of Implementation of Intermittent Straight Catheter Protocol on Rate of Urinary Tract Infections in a Trauma Population

Catheter-associated urinary tract infections (UTIs) are a significant negative outcome. There are previous studies showing advantages in removing Foleys early but no studies of the effect of using intermittent as opposed to Foley catheterization in a trauma population. This study evaluates the effectiveness of a straight catheter protocol implemented in February 2015. A retrospective chart review was performed on all patients admitted to the trauma service at a single institution who had a UTI one year before and one year after protocol implementation on February 18, 2015. The protocol involved removing Foley catheters early and using straight catheterization. Rates were compared with Fisher's exact test and continuous data were compared using student's t test. There were 1477 patients admitted to the trauma service in the control year and 1707 in the study year. The control year had a total of 43 patients with a UTI, 28 of these met inclusion criteria. The intervention year had a total of 35 patients with a UTI and 17 met inclusion criteria. The rate of patients having a UTI went from 0.019 to 0.010 (p = 0.035). In females this rate went from 0.033 to 0.009 (p = 0.007), whereas in males it went from 0.012 to 0.010 (p = 0.837). This study shows a statistically significant improvement in the rate of UTIs after implementing an intermittent catheterization protocol suggesting that this protocol could improve the rate of UTIs in other trauma centers. We use this for all trauma patients, and it is being looked at for use hospital-wide.

The American surgeon. 2017 Jul 01 [Epub]

Katherine Kelley, Theresa Johnson, Jessica Burgess, Timothy J Novosel, Leonard Weireter, Jay N Collins

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