Clinical trial NCT06893562: Evaluating Nine-Year Sustainability After Implementing Evidence-Based Practices to Prevent Urinary Tract Infections and Overfilling of the Bladder in Patients with Hip Fracture
Official title: Nine-Year Sustainability After Implementing Measures to Prevent Catheter- Associated Urinary Tract Infections and Bladder Distension in Patients with Hip Fracture
Study type: OBSERVATIONAL
Overall status: NOT_YET_RECRUITING
Conditions: Urinary Catheters
Urinary Retention
Adherence
Documentation Skill
Sustainability of Innovations
Hip Fracture
UTI - Urinary Tract Infection
Keywords: Sustainability of Innovations
Hip fracture
Urinary Retention
Catheter Associated Urinary Tract Infection
Lead sponsor: Sahlgrenska University Hospital
Sponsor class: OTHER
First posted: 2025-03-25
Enrollment: 750
Sex: ALL
Minimum age (years): 65
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients aged 65 years and older undergoing hip fracture surgery at a university hospital in Sweden.

Brief summary: This study focuses on evaluating the long-term sustainability of a urinary catheter care bundle designed to prevent urinary tract infections and bladder distension in patients undergoing surgery for hip fractures. The intervention, which included two key innovations-a urinary catheter certificate and a nurse-driven urinary catheter protocol, was implemented between 2015 and 2020 and successfully reduced urinary tract infections and bladder distension, previously published. However, due to the pandemic, the initiative was paused and had to be reintroduced in 2022. Now, the study aims to assess the effectiveness of these preventive measures 9 years after their initial implementation. The research will analyze changes in the incidence of urinary tract infections, bladder distension, catheterisation methods, and documentation practices in patients aged 65 and older. The findings will help inform healthcare policies and may have broader implications for preventing adverse events in other surgical patient groups


Eligibility criteria: Inclusion Criteria:

-Hip fracture surgery at the study site, age 65 years and older and cared for in the ortho-geriatric wards.

Exclusion Criteria:

-No catheterisation during hospital stay

Primary outcomes:
measure: Describe changes in the incidence of in-hospital urinary catheter-associated infections; Year 9 will be compared with previously published data from Years 1-5
timeFrame: For one year
Secondary outcomes:
measure: Changes in the incidence of in-hospital acquired bladder distension will be compared; Year 9 will be compared to previously published data from Years 1-5.
timeFrame: For one year.
measure: Changes in urine volume of 500ml and more during hospital stay. Year nine will be compared yera 1-5, previous published data
timeFrame: For one year
measure: Changes in catheterization methods during the hospital stay will be compared, with data from Year 9 compared to previously published data from Years 1-5
timeFrame: For one year
measure: Changes in urinary catheter-related documentation in Year 9 will be compared to previously published data from Years 1-5.
timeFrame: For one year
Other outcomes:
Locations:
city: Mölndal
country: Sweden
facility: Sahlgrenska Academy, Sahlgrenska University hospital/Mölndal
state: Västra Götaland
Study officials:
affiliation: Gothenburg University, Sahlgrenska University Hospital
name: Annette Erichsen, Associate Professor
role: PRINCIPAL_INVESTIGATOR
References:
citation: Erichsen Andersson A, Gillespie BM, Karlsson M, Malchau H, Nellgard B, Wikstrom E, Rogmark C, Tillander J. Reduction of early surgical site and other care related infections in 3553 hip fracture patients: lessons learned from the 5-year Safe Hands project. Antimicrob Resist Infect Control. 2022 Sep 5;11(1):113. doi: 10.1186/s13756-022-01153-4.
citation: Wikstrom E, Dellenborg L, Wallin L, Gillespie BM, Erichsen Andersson A. The Safe Hands Study: Implementing aseptic techniques in the operating room: Facilitating mechanisms for contextual negotiation and collective action. Am J Infect Control. 2019 Mar;47(3):251-257. doi: 10.1016/j.ajic.2018.08.024. Epub 2018 Nov 16.
citation: Erichsen Andersson A, Frodin M, Dellenborg L, Wallin L, Hok J, Gillespie BM, Wikstrom E. Iterative co-creation for improved hand hygiene and aseptic techniques in the operating room: experiences from the safe hands study. BMC Health Serv Res. 2018 Jan 4;18(1):2. doi: 10.1186/s12913-017-2783-1.
citation: Frodin M, Nellgard B, Rogmark C, Gillespie BM, Wikstrom E, Andersson AE. A co-created nurse-driven catheterisation protocol can reduce bladder distension in acute hip fracture patients - results from a longitudinal observational study. BMC Nurs. 2022 Oct 12;21(1):276. doi: 10.1186/s12912-022-01057-z.
citation: Frodin M, Ahlstrom L, Gillespie BM, Rogmark C, Nellgard B, Wikstrom E, Erichsen Andersson A. Effectiveness of implementing a preventive urinary catheter care bundle in hip fracture patients. J Infect Prev. 2022 Mar;23(2):41-48. doi: 10.1177/17571774211060417. Epub 2022 Feb 15.