Strategies to prevent catheter-associated urinary tract infection of patients undergo colorectal resection in the zero-tolerance era

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Abstract Summary

Introduction

Catheter-associated urinary tract infection (CAUTI) is a major cause of hospital-acquired infection. For the Surgical Outcomes Monitoring and Improvement Programme (SOMIP) database from July 2015 to June 2016, symptomatic urinary tract infection rate in different surgical teams under HAHO, the mean score was 2.5%. However, the score in our colorectal surgical team was 5%. Cases were all systematically reviewed. Total 240 cases with colorectal resection performed during the year and 12 cases were post-operatively diagnosed of CAUTI. It was found that majority of the patients were suffered from rectal cancer and intra-abdominal pelvic surgeries were performed. The indwelling catheter should be kept at least 3 to 5 days after operation in order to close monitor the urine output and prevent from dehydration.

Objectives

1.To reduce the rate of catheter-associated urinary tract infection of patients undergo colorectal resection 2.To improve the quality of urinary catheter care in the Department of Surgery

Methodology

In order to compare the difference outcomes for difference interventions, project team planned to conduct the program into two phases within 6 months. In Phase I, five comprehensive strategies would be implemented from October to December, 2017. And in Phase II, five strategies with one more intervention would be implemented from January to March, 2018. Phase I 1.Reinforce strict aseptic technique of catheterization 2.Stop the practice of changing urometer, provide training to healthcare supporting staff and audit the practice 3.Design and use a paper card reminder for daily review catheter maintenance 4.Involve patients and carers for indwelling catheter care during post-operative period 5.Using devices to keep catheter in place after insertion Phase II Using antimicrobial 100% silicone urinary catheter in bundle with five preventive CAUTI interventions

Results & Outcome

Total of 110 patients were recruited in the program. The duration of catheterization at the period of 1/4/2017 – 30/9/17 and 1/10/17 – 31/3/18 was compared. Patients with catheterization more than 4 days (Post-operative Day 3) on 1/4/17 – 30/9/17 were 61.5% but only 34.5% on 1/10/17 – 31/3/17. It has been decreased 27%. Besides, there were total 4 patients with CAUTI during phase I of study. The percentage of CAUTI was 3.5% which was decreased 1.5% compared with the data of SOMIP in 2016. And it was shown that zero case of CAUTI in phase II after using antimicrobal urinary catheter.

 

 

Abstract ID :
HAC599
Submission Type
Authors (including presenting author) :
Lam CP (1), Ng WY (1), Ng YHG (1), Mak HN (1), Wong SLE (1), Chui ST (1), Ho PYB (2)
Affiliation :
(1) Department of Surgery, Prince of Wales Hospital, (2) Central Nursing Division, Prince of Wales Hospital

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