Abstract :
BACKGROUND: Palomar Medical Center (PMC) and Pomerado Hospital (PH) are two hospitals within one system; PMC is a 333-bed trauma hospital, and PH is a 105-bed acute-care facility. An IC Foley system using a silver-alloy/hydrogel Foley catheter, was introduced in January 1999 at both facilities with an initial reduction of catheter-associated urinary tract infection (CA-UTI) rate of 58% at PMC and 86% at PH. By mid-2002, PMC discontinued the use of the IC Foley system, while PH continued its use on all patients needing a Foley catheter.
OBJECTIVE: To demonstrate that continued use of the IC Foley system reduces the rate of CA-UTI.
METHOD: A retrospective study was conducted at both facilities on four different periods on all patients who developed CA-UTI: Period I is to establish baseline data; Period II is an evaluation period followed after the implementation of the change; Period III is the validation period, exactly 1 year from the time both hospitals started using the IC Foley system; and Period IV is revalidation period, 5 months after PMC discontinued its use.
RESULTS: Period I (January 1–April 1999): a CA-UTI rate of 2.6/1000 patient days for both hospitals was obtained. Period II (November 1, 2000–February 28, 2001): CA-UTI rate for PMC is 1.1/1000 patient days and 0.37/1000 patient days for PH, a decrease of 58% (p= <0.001) and 87%, respectively. To validate these results, a second chart review was conducted to reveal a CA-UTI rate of 1.1/1000 patient days for PMC and 0.34/1000 patient days for PH. This data is consistent with the previous period. Five months after discontinuing the use of the IC Foley system at PMC, there is a noticeable 100% increase in CA-UTI, from 1.1/1000 patient days to 2.2/1000 patient days (p=0.003). PH remained at a low rate of 0.44/1000 patient days (p=<0.002)
CONCLUSION: Continued use of the IC Foley system reduces the rate of catheter-associated urinary tract infection.
