Reducing urinary tract infections in catheterized patients.

To compare the effectiveness of two drainage systems in controlling urinary tract infections (UTIs), 65 elderly home care patients with indwelling urinary catheters participated in a retrospective intervention study. The patients first used a Foley drainable bag (DB) system, followed by a nondrainable one (NDB). Both systems used a Foley catheter. Data were obtained from physicians, nurses, caregivers, and patients regarding the number of UTIs and hospitalizations that occurred when using each system. Using the DB, 65 patients had 1,395 UTIs, 27 of which required hospitalization. Using the NDB, 2 patients had 71 UTIs, 2 of which required hospitalization. The cost for the non-hospitalization UTIs with DBs was estimated at $1,153,665 compared to $57,890 with NDBs. The hospital costs with DBs were estimated at $274,170 and $15,540 with NDBs. Because DBs were used longer than NDBs (mean = 44.4 months and 8.8 months, respectively), patients who used each bag for the same period of time were compared. When these patients used NDBs they had significantly fewer UTIs (56, with one hospitalization for 7 days) than when they used DBs (242, with 10 hospitalizations for 37 days). Although the cost of purchasing the non-replaceable NDBs is greater, the use of NDBs drastically reduced levels of infection as well as the overall cost to maintain catheterized patients.