Division of Infectious Diseases, New York Medical College, Valhalla, NY.
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.
Am J Infect Control. 2022 Aug;50(8):954-959. doi: 10.1016/j.ajic.2021.11.032. Epub 2021 Dec 9.
Urinary tract infections are the leading cause of nosocomial infections in the United States. The major contributing factor is the placement of indwelling urinary catheters.
Following a chart review of adult patients hospitalized at a tertiary care medical center who required the use of a short-term (≤ 2 weeks) indwelling urinary catheter, a collaborative effort was initiated by an Infectious Diseases physician to develop protocols focused on the clinical service involved for the expeditious removal of short-term indwelling urinary catheters. The protocols relied in part on the standards of practice by pertinent medical/surgical subspecialty societies. Usage of urinary catheters and duration of hospitalization following implementation of the protocols was assessed.
Based on a multivariate analysis controlling for demographic variables, comorbidities, medical vs surgical service, and indication for the urinary catheterization, the median duration of catheterization was significantly reduced from 6.7 days to 3.6 days after the protocols were initiated (P < .001), and the median duration of hospitalization was significantly reduced from 9.5 days to 5.9 days (P < .001). No patient had to have the urinary catheter reinserted.
Development of collaborative protocols for the removal of short-term indwelling urinary catheters significantly reduced both the duration of catheterization and the duration of hospitalization.
尿路感染是美国医院感染的主要原因。主要的致病因素是留置导尿管的使用。
对在三级医疗中心住院且需要使用短期(≤2 周)留置导尿管的成年患者进行病历回顾后,传染病医生发起了一项合作努力,制定了专注于临床服务的方案,以迅速拔除短期留置导尿管。该方案部分依赖于相关医学/外科专业协会的实践标准。评估了方案实施后导尿管的使用情况和住院时间。
根据多变量分析,控制人口统计学变量、合并症、医疗与外科服务以及导尿的适应证,在实施方案后,导尿管留置时间从 6.7 天显著缩短至 3.6 天(P<0.001),住院时间从 9.5 天显著缩短至 5.9 天(P<0.001)。没有患者需要重新插入导尿管。
制定短期留置导尿管拔除的协作方案显著缩短了导尿管留置时间和住院时间。