Prevention of catheter-associated infection: effect of an intervention on the knowledge of intensivists
DOI:
https://doi.org/10.15343/0104-7809.202347e12792022PKeywords:
Urinary Catheters, Catheter-Related Infections, Patient safety, Knowledge, Hospital Infections. Risk factors. Bacterial infections. Intensive care units.Abstract
Urinary tract infection is one of the most common problems during health care, especially in the intensive care unit, and is mostly associated with the use of a urinary catheter, contributing significantly to mortality, morbidity, and the cost of treatment. The objective of this study was to evaluate the effect of an educational intervention on the knowledge of intensive care professionals upon measures to prevent urinary tract infections associated with the use of a urinary catheter. This is a before-and-after intervention study, carried out in a ten-bed intensive care unit in a high-complexity hospital. Data collection included three moments: pre-intervention, intervention, and post-intervention, carried out between January 2018 and January 2019. In the pre- and post-intervention, an interview was carried out using a structured questionnaire. The intervention took place through a training session with active methodologies and practical demonstrations. There was a trend towards increased knowledge in all items evaluated for the prevention of urinary tract infections associated with the use of a urinary catheter, with significant differences (p<0.05) concerning hand hygiene, indications for catheter insertion bladder, barrier measures in the insertion technique, and prevention of this infection during manipulation and maintenance of the bladder catheter. The intervention provided an increase in the knowledge of professionals about prevention measures. However, gaps related to these practices were still being verified and long-term interventions should be conducted with a view to the improvement and safety of care.
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Li F, Song M, Xu L, Deng B, Zhu S, Li X. Risk factors for catheter-associated urinary tract infection among hospitalized patients: A systematic review and meta-analysis of observational studies. J Adv Nurs. 2019 Mar; 75(3): 517-527. doi: 10.1111/jan.13863.
Gould CV, Umscheid CA, Agarwal RK, Kuntz G, Pegues DA; Healthcare Infection Control Practices Advisory Committee. Guideline for pre vention of catheter-associated urinary tract infections 2009. Infect Control Hosp Epidemiol. 2010 Apr; 31(4): 319-326. doi: 10.1086/651091.
Mota EC, Oliveira AC. Prevenção de infecção do trato urinário associada a cateter: qual o gap na prática clínica? Texto Contexto Enferm. 2019; 28: e20180050. doi: http://dx.doi.org/10.1590/1980-265x-tce-2018-0050
Mota EC, Oliveira AC. Catheter-associated urinary tract infection: why do not we control this adverse event? Rev Esc Enferm USP. 2019; 53: e03452. doi: http://dx.doi.org/10.1590/S1980-220X2018007503452
Feng YH, Lu CY. [Factors Associated With Catheter-Associated Urinary Tract Infection in Patients in the Intensive Care Unit]. Hu Li Za Zhi. 2022;69(6):56-64. Chinese. doi: 10.6224/JN.202212_69(6).08.
Institute for healthcare improvement (IHI). How-to Guide: Prevent Catheter-Associated Urinary Tract Infections. [publicação na web]; Cambri dge. 2011 acesso em 14 de dezembro de 2021. Disponível em: http://www.ihi.org/resources/Pages/Tools/HowtoGuidePreventCatheterAsso ciatedUrinaryTractInfection.aspx
Rubi H, Mudey G, Kunjalwar R. Catheter-Associated Urinary Tract Infection (CAUTI). Cureus. 2022; 14(10): e30385. doi: 10.7759/cureus.30385.
Lo E, Nicolle LE, Coffin SE, Gould C, Maragakis LL, Meddings J, et al. Strategies to Prevent Catheter-Associated Urinary Tract Infections in Acute Care Hospitals: 2014 Update. Infect Control Hosp Epidemiol. 2014; 5(35): 464-479. doi: 10.1086/675718
Agência Nacional de Vigilância Sanitária (Anvisa). Medidas de Prevenção de Infecção Relacionada à Assistência à Saúde [publicação na web]; Brasília. 2017 acesso em 14 de dezembro de 2021. Disponível em: http://portal.anvisa.gov.br/documents/33852/3507912/Caderno+4+Medi das+de+Prevenção+de+Infecção+Relacionada+à+Assistência+à+Saúde/a3f23dfb-2c54-4e64-881c-fccf9220c373
Oliveira AC, Pinto SA. Participação do paciente na higienização das mãos entre profissionais de saúde. Rev Bras Enferm. 2018; 71(2): 259- 264. doi: https://doi.org/10.1590/0034-7167-2016-0124
Shehu NY, Onyedibe KI, Igbanugo JS, Okolo MO, Gomerep SS, Isa SE, et al. Hand hygiene knowledge, training and practice: A cross-sectional study in a tertiary health institution, North-central Nigeria. Niger J Clin Pract. 2019 Jul;22(7):1008-1013. doi: 10.4103/njcp.njcp_204_18.
Yadav SK, Giri A. Assessment of Hand Hygiene Knowledge among Residents and Nursing staff s at Nobel Medical College Teaching Hospital, Biratnagar. J Nepal Paediatr Soc. 2018; 38(2): 69-73. doi: https://doi.org/10.3126/jnps.v38i2.20547
Jansson MM, Syrjälä HP, Ohtonen PP, Meriläinen MH, Kyngäs HA, Ala-Kokko TI. Simulation education as a single intervention does not impro ve hand hygiene practices: A randomized controlled follow-up study. Am J Infect Control. 2016; 44(6): 625-630. doi: 10.1016/j.ajic.2015.12.030
Saffari M, Ghanizadeh G, Fattahipour R, Khalaji K, Pakpour AH, Koenig HG. Effect of the Intelligent Health Messenger Box on health care pro fessionals’ knowledge, attitudes, and practice related to hand hygiene and hand bacteria counts. Am J Infect Control. 2016; 44(12): e283-e285. doi: 10.1016/j.ajic.2016.09.011
Souza LM, Ramos MF, Becker ES, Meirelles LC, Monteiro SA. Adesão dos profissionais de terapia intensiva aos cinco momentos da higieni zação das mãos. Rev Gaúcha Enferm. 2015; 36(4): 21-28. doi: https://doi.org/10.1590/1983-1447.2015.04.49090
Jain M, Dogra V, Mishra B, Thakur A, Loomba PS. Knowledge and attitude of doctors and nurses regarding indications for catheterization and prevention of catheter-associated urinary tract infection in a tertiary care hospital. Indian J Crit Care Med. 2015; 19(2): 76-81. doi: 10.4103/0972- 5229.151014
Niederhauser A, Züllig S, Marschall J, Schweiger A, John G, Kuster SP, Schwappach DL; progress! Safe Urinary Catheterization Collaboration Group; progress! Safe urinary catheterization collaboration group. Change in staff perspectives on indwelling urinary catheter use after imple mentation of an intervention bundle in seven Swiss acute care hospitals: results of a before/after survey study. BMJ Open. 2019 Oct 28; 9(10): e028740. doi: 10.1136/bmjopen-2018-028740
Niederhauser A, Züllig S, Marschall J, Schwappach DL; progress! Safe Urinary Catheterization Collaboration Group. Nurses' and Physicians' Perceptions of Indwelling Urinary Catheter Practices and Culture in Their Institutions. J Patient Saf. 2020 Jun; 16(2): e82-e89. doi: 10.1097/ PTS.0000000000000502
Gray D, Nussle R, Cruz A, Kane G, Toomey M, Bay C, Ostovar GA. Effects of a catheter-associated urinary tract infection prevention cam paign on infection rate, catheter utilization, and health care workers' perspective at a community safety net hospital. Am J Infect Control. 2016 Jan 1;44(1):115-116. doi: 10.1016/j.ajic.2015.08.011
Huang A, Hong W, Zhao B, Lin J, Xi R, Wang Y. Knowledge, attitudes and practices concerning catheter-associated urinary tract infection amongst healthcare workers: a mixed methods systematic review. Nurs Open. 2022. doi: 10.1002/nop2.1384.
Nogueira HKL, Góes ACF; Simões NA, Fernandes MS, Fernandes MS. Conhecimento de profissionais intensivistas sobre o bundle para a prevenção de infecção do trato urinário associada ao uso de sondas. Rev enferm UFPE on line [revista em Internet] 2017. [acesso 19 de outubro de 2021]; 11(12): 4817-4825. Disponível em: https://periodicos.ufpe.br/revistas/revistaenfermagem/article/view/15209
Alhabdan N, Alyaemni A, Aljuaid MM, Baydoun A, Hamidi S. Impact of Implementing Key Performance Indicators on Catheter-Associated Urinary Tract Infection (CAUTI) Rates Among Adult ICU Patients in Saudi Arabia. Clinicoecon Outcomes Res. 2023; 19(5):41-49. doi: 10.2147/CEOR.S396160.
Davies PE, Daley MJ, Hecht J, Hobbs A, Burger C, Watkins L, et al. Effectiveness of a bundled approach to reduce urinary catheters and infection rates in trauma patients. Am J Infect Control. 2018; 46(7): 758-763. doi: 10.1016/j.ajic.2017.11.032. 24. Miranda AL, Oliveira AL, Nacer DT, Aguiar CA. Results after implementation of a protocol on the incidence of urinary tract infection in an intensive care unit. Rev Lat Am Enfermagem. 2016;
Miranda AL, Oliveira AL, Nacer DT, Aguiar CA. Results after implementation of a protocol on the incidence of urinary tract infection in an intensive care unit. Rev Lat Am Enfermagem. 2016; 24: e2804. doi: 10.1590/1518-8345.0866.2804
Ferguson A. Implementing a CAUTI Prevention Program in an Acute Care Hospital Setting. Urologic Nursig. 2018; 38(6): 273-81. doi: 10.7257/1053-816X.2018.38.6.273
Saint S, Greene MT, Krein SL, Rogers MA, Ratz D, Fowler KE, et al. A program to prevent catheter-associated urinary tract infection in acute care. N Engl J Med. 2016; 374(22): 2111-2119. doi: 10.1056/NEJMoa1504906
Chandramohan S, Navalkele B, Mushtaq A, Krishna A, Kacir J, Chopra T. Impact of a Multidisciplinary Infection Prevention Initiative on Central Line and Urinary Catheter Utilization in a Long-term Acute Care Hospital. Open Forum Infect Dis. 2018 Jul 26;5(7):ofy156. doi: 10.1093/ofid/ ofy156.
Wang R, Scutari T, Tunitsky-Bitton E. Implementation of a clinical protocol to reduce urinary tract infections among women with urinary reten tion after pelvic reconstructive surgery. J Obstet Gynaecol Can. 2022; 21:S1701-2163(22)00788-5. doi: 10.1016/j.jogc.2022.11.014.
Afzal MF, Hamid MH, Parveen A, Hanif A. Educational intervention to improve the knowledge of hand hygiene in pediatric residents and nurses. Pak J Med Sci. 2019; 35(3): 771-774. doi: 10.12669/pjms.35.3.388.
Schweiger A, Kuster SP, Maag J, Züllig S, Bertschy S, Bortolin E, et al. Impact of an evidence-based intervention on urinary catheter utilization, associated process indicators, and infectious and non-infectious outcomes. J Hosp Infect. 2020;106(2):364-371. doi: 10.1016/j.jhin.2020.07.002
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