Jundishapur Scientific Medical Journal

Jundishapur Scientific Medical Journal

Implementing Educational, Executive and Managerial Strategies (Interventions) to Reduce Urinary Catheter Utilizations in a University Hospital

Document Type : Original Article

Authors
Negin Esmailpour 1
Shirin Afhami 1
Mahboobeh Alizadeh 2
Seyed Majid Mousavi Movahhed 3
Forough Goudarzi 4
Ramin Mehrdad 5
Farnaz Etesam 6
Mahnaz Montazeri 7
1 Associate Professor of Infectious Disease, Department of Infectious Disease and Tropical Medicine, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
2 Development and clinical Research Center, Department of Infectious Diseases and Tropical Medicine, Nosocomial Infections Fellowship, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran.
3 Associate Professor of Nephrology, Department of Internal Medicine, School of Medicine, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran.
4 Department of Epidemiology Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
5 Professor of Occupational Medicine, Department of Occupational Medicine, School of Medicine, Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran.
6 Associate Professor of Psychosomatic Medicine, Department of Psychiatry, School of Medicine, Psychosomatic Medicine Research Center, Roozbeh Hospital, Imam Khomeini Hospital Complex,Tehran University of Medical Sciences, Tehran, Iran
7 Assistant Professor of Infectious Disease, Department of Infectious Disease and Tropical Medicine, School of Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
10.32592/jsmj.23.5.448
Abstract
Background and Objectives This study was conducted with the aim of investigating methods to reduce the use of urinary catheters in hospitalized patients, which can reduce the occurrence of urinary infections.
Subjects and Methods This prospective study was conducted during 10 months by collecting information from the files of 694 patients (in two groups before and after the intervention) in the non-Intensive Care Unit wards of a university hospital. The required information before and after the educational and managerial interventions were collected and compared.
Results In the pre-intervention phase, 217 out of 347 patients (62.5%) and in the post-intervention phase, 199 out of 347 patients (57.3%) were male. Before the intervention, the average duration of hospitalization and urinary catheter utilization days were 8.7 and 7.9 days, respectively, which were decreased to 7.2 and 6.3 days, respectively, after the intervention. After the intervention, the number of catheters that were placed by the doctor's written order increased significantly (P-value: 0.002); Also, after the intervention, the cases of catheterization with indication increased significantly (P-value: 0.001). The most common indication for urinary catheter insertion was before and during surgery and later, was severe weakness of the patient to get out of bed.
Conclusion Combination of educational, executive and managerial interventions can reduce the number of urinary catheter insertion without physician's order and the number of urinary catheter insertion without indication. In this study, the number of cases who used catheter due to inability of getting out of bed, did not change significantly by the interventions.
Keywords
Urinary catheters
catheter-associated urinary tract infection
healthcare associated infection
Interventional strategy
Subjects

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Jundishapur Scientific Medical Journal
Volume 23, Issue 5 - Serial Number 152
September and October 2024
Pages 448-460

  • Receive Date 13 March 2024
  • Revise Date 21 July 2024
  • Accept Date 11 August 2024