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Reducing unnecessary urethral catheter use in Japanese intensive care units: A multicenter interventional study

  • Akira Kuriyama (a1), Karen E. Fowler (a2), Jennifer Meddings (a2) (a3) (a4), Hiromasa Irie (a5), Daisuke Kawakami (a6), Hiroshi Iwasaki (a7), Masaaki Sakuraya (a8), Kohta Katayama (a9), Yasuharu Tokuda (a10) and Sanjay Saint (a2) (a3)...

Abstract

We conducted a preintervention–postintervention study to assess the effectiveness of a multimodal approach to reduce unnecessary urethral catheters in 5 Japanese intensive care units. After the intervention urethral catheter point prevalence decreased by 18%, from 79% preintervention to 61% postintervention, and catheter appropriateness increased by 28%, from 57% preintervention to 85% postintervention.

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Corresponding author

Author for correspondence: Akira Kuriyama, MD, MPH, Emergency and Critical Care Center, Kurashiki Central Hospital, 1-1-1 Miwa Kurashiki Okayama 710-8602 Japan. Email: akira.kuriyama.jpn@gmail.com

References

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1. Saint, S, Trautner, BW, Fowler, KE, et al. A multicenter study of patient-reported infectious and noninfectious complications associated with indwelling urethral catheters. JAMA Intern Med 2018;178:10781085.
2. Kennedy, EH, Greene, MT, Saint, S. Estimating hospital costs of catheter-associated urinary tract infection. J Hosp Med 2013;8:519522.
3. Meddings, J, Rogers, MA, Krein, SL, Fakih, MG, Olmsted, RN, Saint, S. Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review. BMJ Qual Saf 2014;23:277289.
4. Greene, MT, Fakih, MG, Fowler, KE, et al. Regional variation in urinary catheter use and catheter-associated urinary tract infection: results from a national collaborative. Infect Control Hosp Epidemiol 2014;35 suppl 3:S99S106.
5. Kuriyama, A, Takada, T, Irie, H, et al. Prevalence and appropriateness of urinary catheters in Japanese intensive care units: results from a multicenter point prevalence study. Clin Infect Dis 2017;64 suppl 2:S127S130.
6. Gould, CV, Umscheid, CA, Agarwal, RK, Kuntz, G, Pegues, DA, Healthcare Infection Control Practices Advisory C. Guideline for prevention of catheter-associated urinary tract infections 2009. Infect Control Hosp Epidemiol 2010;31:319326.
7. Meddings, J, Saint, S, Fowler, KE, et al. The Ann Arbor criteria for appropriate urinary catheter use in hospitalized medical patients: results obtained by using the RAND/UCLA appropriateness method. Ann Intern Med 2015;162 suppl 9:S1S34.
8. Saint, S, Kaufman, SR, Thompson, M, Rogers, MA, Chenoweth, CE. A reminder reduces urinary catheterization in hospitalized patients. Jt Comm J Qual Patient Saf 2005;31:455462.
9. Huang, WC, Wann, SR, Lin, SL, et al. Catheter-associated urinary tract infections in intensive care units can be reduced by prompting physicians to remove unnecessary catheters. Infect Control Hosp Epidemiol 2004;25:974978.
10. Knoll, BM, Wright, D, Ellingson, L, et al. Reduction of inappropriate urinary catheter use at a Veterans’ Affairs hospital through a multifaceted quality improvement project. Clin Infect Dis 2011;52:12831290.

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Appendix Figure 1 and Appendix Tables 1-2

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Reducing unnecessary urethral catheter use in Japanese intensive care units: A multicenter interventional study

  • Akira Kuriyama (a1), Karen E. Fowler (a2), Jennifer Meddings (a2) (a3) (a4), Hiromasa Irie (a5), Daisuke Kawakami (a6), Hiroshi Iwasaki (a7), Masaaki Sakuraya (a8), Kohta Katayama (a9), Yasuharu Tokuda (a10) and Sanjay Saint (a2) (a3)...

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