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    ABSTRACT: BACKGROUND: Catheter-associated urinary tract infections (CAUTIs) are among the most common health care-associated infections in the United States, yet little is known about the prevention and epidemiology of pediatric CAUTIs. METHODS: An observational study was conducted to assess the impact of a CAUTI quality improvement prevention bundle that included institution-wide standardization of and training on urinary catheter insertion and maintenance practices, daily review of catheter necessity, and rapid review of all CAUTIs. Poisson regression was used to determine the impact of the bundle on CAUTI rates. A retrospective cohort study was performed to describe the epidemiology of incident pediatric CAUTIs at a tertiary care children's hospital over a 3-year period (June 2009 to June 2012). RESULTS: Implementation of the CAUTI prevention bundle was associated with a 50% reduction in the mean monthly CAUTI rate (95% confidence interval: -1.28 to -0.12; P = .02) from 5.41 to 2.49 per 1000 catheter-days. The median monthly catheter utilization ratio remained unchanged; similar to 90% of patients had an indication for urinary catheterization. Forty-four patients experienced 57 CAUTIs over the study period. Most patients with CAUTIs were female (75%), received care in the pediatric or cardiac ICUs (70%), and had at least 1 complex chronic condition (98%). Nearly 90% of patients who developed a CAUTI had a recognized indication for initial catheter placement. CONCLUSIONS: CAUTI is a common pediatric health care-associated infection. Implementation of a prevention bundle can significantly reduce CAUTI rates in children.
    Pediatrics 08/2014; 134(3). DOI:10.1542/peds.2013-3470 · 5.30 Impact Factor
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    ABSTRACT: The frequency of changing long-term indwelling urinary catheters is a subject of debate. The focus of this integrative review is to determine if routinely scheduled changes of long-term indwelling urinary catheters in older adults is evidence-based. There are no current research studies specifically studying routine changes of chronic indwelling urinary catheters available to support or refute this common practice. The frequency of chronic urinary catheter changes should be tailored to the individual patient and occur as clinically indicated. Rigorous research studies are needed to advance the science used to provide evidence-based care for this vulnerable population.
    Geriatric nursing (New York, N.Y.) 06/2014; 35(5). DOI:10.1016/j.gerinurse.2014.04.010 · 0.92 Impact Factor
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    ABSTRACT: Limited data exist on the use of infection prevention practices in Japan. We conducted a nationwide survey to examine the use of recommended infection prevention strategies and factors affecting their use in Japanese hospitals.


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Nov 10, 2014