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URINARY CATHETER INFECTION RISK HOSPITAL REMINDER SYSTEM Contact Information

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Millions of hospital patients could be spared the humiliation and infection risk that come with a urine-collecting catheter, a new study finds, if hospitals used a simple reminder system to prompt doctors to remove the devices after two days.




Newswise — Millions of hospital patients could be spared the humiliation and infection risk that come with a urine-collecting catheter, a new study finds, if hospitals used a simple reminder system to prompt doctors to remove the devices after two days.

About 25 percent of hospital patients at any given time have urinary catheters — and a substantial proportion of patients have them much longer than they really need them, experts say. This greatly raises their risk of getting a painful urinary tract infection or even a blood infection.

But a new University of Michigan Health System study, funded by a patient safety grant from the Blue Cross Blue Shield of Michigan Foundation, shows that simply having nurses flag patients’ records with a written reminder can jog the memory of busy doctors, prompt them to consider removing the catheter, and lead to a much shorter time with a catheter for many patients. The study is published in the August issue of the Joint Commission Journal on Quality and Patient Safety.

The written-reminder system isn’t expensive, and in fact the study finds that its cost equals or is less than the savings that a hospital could achieve by reducing infections among patients. An estimated 40 percent of infections developed by patients during their hospital stay are urinary tract infections, and most of these infections are due to urinary catheters. The cost of treating each infection that causes symptoms is estimated to be at least $500.

“Doctors are responsible for ordering the removal of catheters, but research has shown that many of them forget which patients have catheters and how long they have them,” says lead author Sanjay Saint, M.D., M.P.H., a hospitalist at the VA Ann Arbor Healthcare System and an associate professor of internal medicine at the U-M Medical School. “Our reminder system helps doctors do the right thing,” he adds.

“Catheter reminders may become automatic as hospitals implement computerized doctors-orders systems. But since about 90 percent of American hospitals still don’t have such systems, our study suggests that written reminders should be used in their place,” says Saint, the director of the UMHS/VA Patient Safety Enhancement Program, which researches ways to prevent patient injuries and adverse events during hospital care. He is also a member of the Patient Safety Committee that oversees clinical patient safety improvement efforts at UMHS.

Ira Strumwasser, Ph.D., president and CEO of BCBSM Foundation, says, “This is a terrific example of how a simple change in a process can make a real difference in lessening the risk of infection for thousands of patients, as well as reduce costs associated with treating infections.”

The controlled trial, carried out for 16 months in four wards of the U-M’s University Hospital, involved patients who had been admitted for surgery or with general ailments including kidney and lung problems. Two of the wards used the reminder system and two did not, but a nurse checked the records of every patient each day.

The first eight months of the study gathered baseline data on catheter use. Then, for the next eight months on the two wards where reminders were used, the nurse attached a pre-written order and a sign-here sticker to each patient’s chart every day after the catheter had been in place for 48 hours. After about four months, she began paging doctors who didn’t fill out the order to either continue the catheter or remove it. The medical director of the Infection Control & Epidemiology division, Carol Chenoweth, M.D., began e-mailing doctors as they started their one-month rotations on the wards.




http://www.newswise.com/articles/view/513421/