Abstract :
BACKGROUND/OBJECTIVES: As the number of elderly, immunocompromised and/or patients with severe co-morbidities has risen in the inpatient setting, the use of indwelling bladder catheters has increased as well. This 200-bed acute care community-based hospital had seen a gradual increase in the number of catheter-associated urinary tract infections (CAUTIs) using a standard silicone indwelling catheter. In an effort to positively impact the CAUTI rate, a decision was made to evaluate the effectiveness of silver-coated 100% silicone indwelling catheter.
METHODS: During a three month trial period, in 2005, a concurrent housewide CAUTI rate was performed during which only silver-coated 100% silicone catheters were inserted. This rate was compared to the CAUTI rate established for the same three months, in 2004, when standard silicone catheters were used. Definitions based on CDC criteria for nosocomial UTI were utilized for case determination. Numerators reflected only indwelling catheter-associated UTIs. The CAUTI rate was computed with a denominator of risk adjusted adult inpatient days in both time periods and expressed as a rate per 1000 adult inpatient days. Potential records warranting review were selected from laboratory records of positive culture results. During the evaluation period, nursing staff were not provided with any information that would change their current practice for inserting and caring for indwelling catheters.
RESULTS: The evaluation period resulted in a 57% decrease in CAUTIs. During 2004, the CAUTI rate was 0.48 infections per 1000 in-patient days. Using silver-coated 100% silicone catheters, the CAUTI rate, in 2005, was 0.21 infections per 1000 in-patient days.
CONCLUSIONS: Silver-coated 100% silicone catheters can be effective in reducing the number of CAUTIs in an acute care community-based hospital. Following this evaluation, the standard for this hospital is the silver-coated 100% silicone catheter. Six months following the evaluation, we continue to see a decrease in CAUTIs. The CAUTI rate for the 6 months following the evaluation period was 0.52 infections per 1000 patient days compared to a rate of 1.03 infections per 1000 patient days during the same period in 2004.
