Variation of diagnosis and treatment of catheter-associated urinary tract infections: an online survey among caretakers involved.

IF 2.6 4区 医学 Q2 UROLOGY & NEPHROLOGY Therapeutic Advances in Urology Pub Date : 2023-01-01 DOI:10.1177/17562872231191305
Tess van Doorn, Sophie A Berendsen, Rosa L Coolen, Jeroen R Scheepe, Bertil F M Blok
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Abstract

Background: The diagnosis of a clinically significant catheter-associated urinary tract infection (CAUTI) in patients performing clean intermittent catheterization (CIC) or with an indwelling catheter (IC) can be challenging.

Objective: To get an insight into the variation of the used definition, diagnosis and management of CAUTIs by relevant healthcare workers in the Netherlands.

Design: An online clinical scenario-based survey.

Methods: The survey was built in Limesurvey and distributed to healthcare workers from randomly selected urology departments, rehabilitation departments/centres and general practice offices between January and May 2022. Questions regarding their field of experience, management strategies, used guidelines and two hypothetical cases with clinical scenarios of a possible CAUTI were included.

Results: A total of 172 individuals participated, of which 112 completed the survey. In all, 32 individuals who completed the survey partially were also included. Participants consisted of 68 [44 urologists, 22 rehabilitation doctors (RDs) and 2 general practitioners (GPs)] doctors, 60 nurses (46 from the urology department and 14 from rehabilitation centres/departments) and 16 medical assistants (13 from urology department and 3 from GP offices). The majority consulted patients with an IC or on CIC on a daily/weekly or monthly basis. In all, 35 urologists (79.5%), 9 RDs (40.9%), 21 (45.7%) nurses in the urology department and 6 (42.9%) nurses from a rehabilitation department/centre indicated bladder irrigation as a treatment option for prevention/treatment of CAUTIs, treatment of symptoms or treatment of blockage of the catheter. In the clinical scenarios presented, treatment discrepancies were seen between subspecialties and healthcare workers. Various guidelines were named for the definition of CAUTIs.

Conclusion: A considerable variation in diagnoses and management of CAUTIs between the healthcare workers involved was seen. Uniformity in diagnosing and managing CAUTIs, to prevent overtreatment and possible resistance to antibiotics, is advised. Suitable multidisciplinary guidelines are preferred.

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导尿管相关性尿路感染的诊断和治疗差异:一项涉及护理人员的在线调查。
背景:在进行清洁间歇导尿(CIC)或留置导尿(IC)的患者中诊断具有临床意义的导管相关性尿路感染(CAUTI)可能具有挑战性。目的:了解荷兰相关医护人员对CAUTIs的使用定义、诊断和管理的差异。设计:基于临床场景的在线调查。方法:采用limessurvey软件进行调查,于2022年1 - 5月随机抽取泌尿外科、康复科/中心和全科诊所的医护人员进行调查。问题包括他们的经验领域、管理策略、使用的指南和两个可能的CAUTI临床情景的假设病例。结果:172人参与,其中112人完成问卷调查。总共有32名部分完成调查的人也被包括在内。参与者包括68名[44名泌尿科医生,22名康复医生和2名全科医生]医生,60名护士(46名来自泌尿科,14名来自康复中心/部门)和16名医疗助理(13名来自泌尿科,3名来自全科医生)。大多数人每天/每周或每月咨询有CIC或正在CIC的患者。共有35名泌尿科医生(79.5%)、9名rd(40.9%)、21名泌尿科护士(45.7%)和6名康复科/中心护士(42.9%)表示膀胱冲洗是预防/治疗CAUTIs、治疗症状或治疗导管堵塞的一种治疗选择。在临床方案提出,治疗差异是亚专科和卫生保健工作者之间看到。根据CAUTIs的定义命名了各种指南。结论:不同医护人员对CAUTIs的诊断和处理存在很大差异。建议统一诊断和管理CAUTIs,以防止过度治疗和可能的抗生素耐药性。合适的多学科指南是首选。
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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
39
审稿时长
10 weeks
期刊介绍: Therapeutic Advances in Urology delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of urology. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in urology, providing a forum in print and online for publishing the highest quality articles in this area. The editors welcome articles of current interest across all areas of urology, including treatment of urological disorders, with a focus on emerging pharmacological therapies.
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