Reduction of Catheter-associated Urinary Tract Infection With a Daily Nursing Review of the Indication
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.
Urinary Tract Infections
Urinary Tract; Accessory
Other: Daily review
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Prevention
|Official Title:||Reduction of Catheter-associated Urinary Tract Infection With a Daily Nursing Review of the Indication. Randomized Controlled Trial|
- Rate of Catheter-associated Urinary Tract Infection [ Time Frame: Until 7 days after the withdrawal of the catheter or at discharge (whichever comes first) ] [ Designated as safety issue: Yes ]
- Catheter Days [ Time Frame: withdrawal of the catheter ] [ Designated as safety issue: No ]The duration of catheterization
|Study Start Date:||November 2009|
|Study Completion Date:||September 2010|
|Primary Completion Date:||September 2010 (Final data collection date for primary outcome measure)|
Experimental: Daily review
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
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
Other Name: Review for indication
No Intervention: Routine care
In the control group, the attending team would remove the catheter as routine, without any suggestion by the research protocol.
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.