Urinary tract infections (UTIs) are very common in hospitals and at home. Around 80% of UTIs are associated with the use of urinary catheters (UCs) (Jorge, Mazza, Mendes, Trevizan & Martins, 2013). Along with pneumonia, catheter-associated urinary tract infection (CAUTI) is the most common hospital-acquired infection (Sopirala, Syed, Jandarov & Lewis, 2018). It is estimated that 26% of hospital admissions involve urinary catheterization (Mitchell et al., 2017), yet around 40% of cases are unnecessary (Wooller et al., 2018). A meta-analysis by Li et al. (2019) revealed that CAUTI occurs at a rate of 13.79 per 1,000 days of catheter use, with an associated prevalence of 9.33%.
CAUTIs increase readmissions, lengthen hospital stays and increase costs. Consequently, they also increase the use of antimicrobials, which contributes to antimicrobial resistance. In terms of management, this data is particularly relevant in a context of economic restrictions and waiting lists that do not meet demand.
In Portugal, as is the case internationally, issues related to HAI prevention and control are a priority. For this reason, several entities have produced evidence-based guidelines to improve healthcare practices and reduce HAIs. In Portugal, the Directorate-General for Health has developed a standard for the prevention of CAUTIs, which takes a multimodal approach and includes an audit grid to assess compliance with the standard. However, the level of compliance with this standard and the indicators related to the use of UC or CAUTI are currently unknown.
Jorge, B., Mazzo, A., Mendes, I., Trevizan, M., & Martins, J. (2013). Infeção do trato urinário relacionada com o uso do cateter: revisão integrativa. Revista de Enfermagem Referência, III Série(11), 125-132. doi:10.12707/riii1271
Li, F., Song, M., Xu, L., Deng, B., Zhu, S., & Li, X. (2019). Risk factors for catheter-associated urinary tract infection among hospitalized patients: A systematic review and meta-analysis of observational studies. J Adv Nurs, 75(3), 517-527. doi:10.1111/jan.13863
Mitchell, B. G., Fasugba, O., Gardner, A., Koerner, J., Collignon, P., Cheng, A. C., . . . Gregory, V. (2017). Reducing catheter-associated urinary tract infections in hospitals: study protocol for a multi-site randomised controlled study. BMJ Open, 7(11), e018871. doi:10.1136/bmjopen-2017-018871
Sopirala, M. M., Syed, A., Jandarov, R., & Lewis, M. (2018). Impact of a change in surveillance definition on performance assessment of a catheter-associated urinary tract infection prevention program at a tertiary care medical center. Am J Infect Control, 46(7), 743-746. doi:10.1016/j.ajic.2018.01.019
Wooller, K. R., Backman, C., Gupta, S., Jennings, A., Hasimja-Saraqini, D., & Forster, A. J. (2018). A pre and post intervention study to reduce unnecessary urinary catheter use on general internal medicine wards of a large academic health science center. BMC Health Serv Res, 18(1), 642. doi:10.1186/s12913-018-3421-2
01/01/2019
Em desenvolvimento
MULTIDISCIPLINARY EVALUATION AND PROMOTION OF TECHNIQUES/CLINICAL PROCEDURES RELATED TO NURSING CARE
Care Systems, Organization, Models, and Technology