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Intensive care unit rounding checklists to reduce catheter-associated urinary tract infections

Published online by Cambridge University Press:  04 March 2020

Nicholas J. Nassikas Open the ORCID record for Nicholas J. Nassikas [Opens in a new window] ,
Joao Filipe G. Monteiro ,
Barbara Pashnik ,
Judith Lynch ,
Gerardo Carino  and
Andrew T. Levinson
Nicholas J. Nassikas*
Affiliation:
Department of Pulmonary, Critical Care, and Sleep Medicine, Brown University, Alpert School of Medicine, Providence, Rhode Island, USA
Joao Filipe G. Monteiro
Affiliation:
Department of Medicine, Rhode Island Hospital, Providence, Rhode Island, USA
Barbara Pashnik
Affiliation:
Miriam Hospital, Providence, Rhode Island, USA
Judith Lynch
Affiliation:
Miriam Hospital, Providence, Rhode Island, USA
Gerardo Carino
Affiliation:
Department of Pulmonary, Critical Care, and Sleep Medicine, Brown University, Alpert School of Medicine, Providence, Rhode Island, USA
Andrew T. Levinson
Affiliation:
Department of Pulmonary, Critical Care, and Sleep Medicine, Brown University, Alpert School of Medicine, Providence, Rhode Island, USA
*
Author for correspondence: Nicholas J. Nassikas, E-mail: [email protected]
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Abstract

Objective:

To assess whether the implementation of an intensive care unit (ICU) rounding checklist reduces the number of catheter-associated urinary tract infections (CAUTIs).

Design:

Retrospective before-and-after study that took place between March 2013 and February 2017.

Setting:

An academic community hospital 16-bed, mixed surgical, cardiac, medical ICU.

Patients:

Participants were all patients admitted to the adult mixed ICU and had a diagnosis of CAUTI.

Intervention:

Initiation of an ICU rounding checklist that prompts physicians to address any use of urinary catheters with analysis comparing the preintervention period before roll out of the rounding checklist versus the postintervention periods.

Results:

There were 19 CAUTIs and 9,288 urinary catheter days (2.04 CAUTIs per 1,000 catheter days). The catheter utilization ratio increased in the first year after the intervention (0.67 vs 0.60; P = .0079), then decreased in the second year after the intervention (0.53 vs 0.60; P = .0992) and in the third year after the intervention (0.53 vs 0.60; P = .0224). The rate of CAUTI (ie, CAUTI per 1,000 urinary catheter days) decreased from 4.62 before the checklist was implemented to 2.12 in the first year after the intervention (P = .2104). The CAUTI rate was 0.45 in the second year (P = .0275) and 0.96 in the third year (P = .0532).

Conclusions:

Our study suggests that utilization of a daily rounding checklist is associated with a decrease in the rates of CAUTI in ICU patients. Incorporating a rounding checklist is feasible in the ICU.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 41 , Issue 6 , June 2020 , pp. 680 - 683
Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved.

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Footnotes

PREVIOUS PRESENTATION: This work was summarized in abstract form at the Society of Critical Care Medicine’s (SCCM) Critical Care Congress on February 27, 2018, in San Antonio, Texas.

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