Reduction of Catheter-associated Urinary Tract Infection With a Daily Nursing Review of the Indication

Study Overview
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Brief Summary
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The purpose of this study is to determine whether the daily nurse review of the indication of the urinary catheter compared to the everyday care of the working staff is effective to reduce the rate of catheter-associated urinary tract infection in adults hospitalized.

Detailed Description
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Healthcare-associated infection (HAI)in hospitalized patients are very frequent, especially the catheter-associated urinary tract infection, which prolongs the hospital stay and costs, and is about 3 times more likely to die during hospitalization than patients not infected. The measures of aseptic insertion and closed systems of collection, as well as the rational use of the probe reduce the risk for infection. A checklist that contains the agreed indications of catheter, related to obstruction, incontinence, skin lesions in sacral region, monitoring or surgical procedures allows the daily review of the indication of the probe. If the patient doesn´t meet at least one of the criteria, should be recommended the withdrawal of the catheter.

Official Title
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Reduction of Catheter-associated Urinary Tract Infection With a Daily Nursing Review of the Indication. Randomized Controlled Trial

Conditions
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Urinary Tract Infections, Urinary Tract; Accessory

Intervention / Treatment
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* Other: Daily review


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Inpatient with a permanent urinary catheter (balloon catheter) Urinary catheter placed in the hospitalization (previous day) or at admission Exclusion Criteria: Urinary tract infection diagnosis at time of the insertion Spinal cord injury or neurogenic bladder at admission

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Daily review<br>In the intervention group a nurse reviewed daily, by using a checklist designed for this study, the indications and pertinence of the catheter. If it was not indicated she asked the doctor to order the removal of the catheter, but the doctor would make the final decision. | Other: Daily review<br>* Daily nursing review of the urinary catheter´s indication. If the patient meets at least one of the entries to stay with bladder catheter, the nurse will record collection in the format but will not contact the health team. If there aren´t indication in the medical record, she contacts at the attending physician and said: Doctor, I didn´t find record in the history of the indication of the urinary catheter, can we withdraw?. If the physician reported the indication, will be recorded in the format without additional comments. The attending physician decides withdraw or no withdraw the urinary catheter<br>* Other names: Review for indication;|
| No Intervention: Routine care<br>In the control group, the attending team would remove the catheter as routine, without any suggestion by the research protocol. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rate of Catheter-associated Urinary Tract Infection |  | Until 7 days after the withdrawal of the catheter or at discharge (whichever comes first) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Catheter Days | The duration of catheterization | withdrawal of the catheter | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Urinary Tract Infections, Catheter-associated urinary tract infections, Prevention and control, Controlled clinical trial