Prevalence of inappropriate urinary catheterization: a preventable risk factor.

Natércia Caramujo, Manuel Carvalho, Helena Caria

Abstract


Healthcare-associated infection is an issue with major socio-economic implications worldwide. Urinary Tract Infection is a Healthcare-Associated infection with a high influence on morbidity and personal impact for patients and their families, also has a great economic impact on institutions. The financial cost of each infection is difficult to estimate. Urinary catheterization is recognized as a main risk factor associated with urinary tract infection. However, their use is often essential in providing health care. The frequency with which catheters are placed and the duration of catheterization determines the magnitude of the risk of infection. If the presence of a urinary catheter is inappropriate, then that risk is an avoidable one. The purpose of this study was to quantify the presence of inappropriate urinary catheterization in a Medicine Department in a general hospital, which involved the analysis of all admitted patients to determine the presence of indwelling catheters, on two different days, and later by means of review of the medical records, to identify the cases that develop urinary tract infection. At the moment of the study there were 160 inpatients and a bladder catheter was present in 20%. The prescription for catheterization was mainly (84,4%) a clinician one. Reason for the permanence of the urinary catheter without appropriate indication, was maybe the absence of an order to remove the catheter. In our study, we found that 25% of patients with a urinary catheter had no clear medical order for it on that day. Another result of the study showed that 12 individuals developed urinary tract infection. In this 12 patients group, five cases had no proper order for a urinary catheter. It might be argued that five urinary tract infections were potentially preventable. These five potentially avoidable infections represent 41.7% of the urinary tract infections diagnosed. This is important data considering the need to improve the quality of care as well as all costs associated with the treatment of urinary tract infections.

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