Improvements in process with a multimodal campaign to reduce urinary tract infections in hospitalised Australian patients
Deborah Rhodes A E , Jacqueline Kennon A , Stacey Aitchison A , Kerrie Watson A , Linda Hornby B , Gillian Land A , Pauline Bass A , Susan McLellan A , Surendra Karki B , Allen C. Cheng A C and Leon J. Worth A DA Infection Prevention and Healthcare Epidemiology Unit, Department of Infectious Diseases, Alfred Health, Vic. 3181, Australia.
B Caulfield Continence Service, Caulfield Hospital, Vic. 3162, Australia.
C Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Vic. 3800, Australia.
D Department of Medicine, University of Melbourne, Vic. 3052, Australia.
E Corresponding author. Email: d.rhodes@alfred.org.au
Healthcare Infection 19(4) 117-121 https://doi.org/10.1071/HI14024
Submitted: 25 July 2014 Accepted: 15 September 2014 Published: 10 November 2014
Abstract
Introduction: In hospitalised patients, the majority of urinary tract infections (UTIs) can be attributed to the use of indwelling urinary catheters (IDCs). However, quality-care practices for catheterised hospitalised patients in Australia are largely unknown. The objective of this study was to evaluate the impact of an educational campaign on the quality of care of IDCs in hospitalised patients, and the proportion of hospitalised patients with UTI.
Methods: A multimodal strategy was developed in an Australian centre to educate regarding prevention of infection and to improve documentation regarding IDCs (June to October 2011). Point-prevalence audits of process measures were conducted at baseline and in early and late post-intervention periods. Administrative coding was used to quantify UTI infections in hospitalised patients.
Results: Documentation of clinical practice regarding IDC insertion and maintenance improved post-intervention and was sustained. Compliance with current best practice for managing IDCs improved in the early post-intervention period, but was not sustained. Administratively coded UTIs decreased by 13% following the intervention.
Conclusions: An organisation-wide multimodal strategy to improve processes concerning IDC care and documentation was successfully implemented, with an associated reduction in UTIs arising during hospital stay. To achieve sustainability, practices must be embedded into routine clinical care.
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