Mazi Waleed Abdulmotalib, Bondad Mylene, Althumali Maryam, Alzahrani Turki
Infection Prevention and Control, Taif Health Cluster, Taif, Kingdom of Saudi Arabia.
Infection Prevention and Control Department, King Abdulaziz Specialist Hospital, Taif, Kingdom of Saudi Arabia.
Infect Prev Pract. 2024 Mar 24;6(2):100362. doi: 10.1016/j.infpip.2024.100362. eCollection 2024 Jun.
The urinary catheter usually leads to a catheter-associated urinary tract infection (CAUTI) contributing to further morbidity and mortality. There is very limited data on the CAUTI incidence rate in high-dependency units (HDUs) in the Kingdom of Saudi Arabia. The institutional CAUTI incidence rate in HDU was six times higher compared to the United States National Healthcare Safety Network (US-NHSN) in 2021.
To reduce 50% CAUTI incidence rate by the end of 2022.
A prospective study was conducted in tertiary HDU from January 2022 to June 2023. A gap analysis was assessed between the hospital practices and the Society Healthcare Epidemiology of America/Infectious Diseases Society of America (SHEA/IDSA) basic recommendations. The Kotter and Rathgebers' changing behavior model was applied at the beginning of the project. Formal education and prevention of CAUTI were applied using the National Strategy Model. Surveillance and statistical data analysis were carried out using US-NHSN guidelines.
The overall CAUTI incidence rate declined from 7.07- to 3.57/1000 urinary catheter days despite of significant increase in the utilization ratio from 0.79 to 0.94 ( value 0.0001). The compliance rate of the bundle CAUTI prevention was improved and sustained above 90%. A CAUTI incidence rate reduction was observed following the combination of the changing behavior and SHEA/IDSA of CAUTI prevention models over 18 months.
We assumed the combination of the changing behavior and the prevention models for a long period is useful in reducing the CAUTI incidence rate and possibly applied to reduce other healthcare-associated infections.
导尿管通常会导致与导尿管相关的尿路感染（CAUTI），进而导致更高的发病率和死亡率。沙特阿拉伯王国高依赖病房（HDU）中CAUTI发病率的数据非常有限。2021年，HDU的机构CAUTI发病率比美国国家医疗安全网络（US-NHSN）高六倍。
到2022年底将CAUTI发病率降低50%。
2022年1月至2023年6月在三级HDU进行了一项前瞻性研究。评估了医院实践与美国医疗保健流行病学学会/美国传染病学会（SHEA/IDSA）基本建议之间的差距分析。在项目开始时应用了科特和拉特格伯斯的行为改变模型。使用国家战略模型进行CAUTI的正规教育和预防。使用US-NHSN指南进行监测和统计数据分析。
尽管使用率从0.79显著提高到0.94（P值0.0001），但总体CAUTI发病率从7.07降至3.57/1000导尿日。CAUTI预防集束措施的依从率得到提高，并持续保持在90%以上。在18个月内，将行为改变模型与SHEA/IDSA的CAUTI预防模型相结合后，观察到CAUTI发病率有所降低。
我们认为长期将行为改变模型与预防模型相结合有助于降低CAUTI发病率，并可能适用于减少其他医疗保健相关感染。
