A single centre point prevalence survey to determine prevalence of indwelling urinary catheter use and nurse-sensitive indicators for the prevention of infection

Abstract

Background

Catheter-associated urinary tract infection (CAUTI) is the most common hospital-acquired infection. Key factors influencing the development of CAUTI are indwelling urinary catheter (IUC) insertion duration and nursing management for the prevention of this complication. There is very little evidence describing practice patterns associated with IUC management. The aim of this study was to determine the prevalence of IUC use within a major metropolitan tertiary-referral teaching hospital and to explore nurse-sensitive indicators for the prevention of CAUTI in this context.

Methods

We conducted a point prevalence survey of IUC use by reviewing every inpatient bed (n = 696) across two sites over a 2-day period in January 2013. Site 1 comprised (n = 520, 74.7%) acute inpatient beds and Site 2 (n = 176, 25.3%) aged care and rehabilitation beds within a single organisation.

Results

At the time of the survey 555 (79.7%) beds were occupied. Few patients (n = 69, 12.4%) had an IUC in situ and a standard Foley's catheter was used for the majority of patients (62, 92.5%). IUC insertion was more prevalent in women over 70 (20, 71.4%) when compared with men (18, 46.2%; χ² 4.24, P = 0.04). Fourteen nurse-sensitive indicators were assessed and although all indictors were not present for any single patient, drainage system management appeared to be in accordancewith recommended guidelines.Of the patients with an IUC12 (17.4%) had a urine sample sent in the 24 h preceding the survey and 5 (41.6%) of these samples were positive for bacterial colonisation.

Conclusion

The prevalence of IUC use in this tertiary teaching hospital was less than that in other centres despite a comparatively older inpatient population in the context of acute care needs. Nurses appear to be proficient in the management of IUC and associated drainage equipment and there is room for interdisciplinary improvement in documentation practices. Future research should test interventions to target appropriate insertion, ongoing need and timely removal of IUC.