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ID
Source
Brief title
Health condition
Catheter- related infection, phlebitis, and bacteremia are associated with an increased morbidity, mortality, and thereby substantial costs. Urinary tract infections is accountable for 40% of all nosocomial infections in Western world hospitals, and 71-80% of these patients had a urinary catheter. Although the incidence of catheter-associated bloodstream infection by peripheral intravenous catheters is low (0.5 per 1000 catheter days), it is important because peripheral intravenous catheters are the most frequently used invasive medical devices in hospitalized patients.
Sponsors and support
Intervention
Outcome measures
Primary outcome
Percentage of inappropriate use of urinary and intravenous catheter on the days of data collection.
Secondary outcome
Catheter-related infections or other complications, catheter re-insertion rate, length of hospital (and ICU) stay, mortality, and costs of the de-implementation strategy and the main health care costs.
Background summary
This RICAT-study aims to reduce the use of urinary and intravenous catheters with an inappropriate indication, and as a result reduce the catheter-related complications. In a multicenter, prospective interrupted time series analysis, several interventions to avoid inappropriate use of catheters will be conducted in seven hospitals in the Netherlands. If (cost-)effective it provides a tool for a nationwide approach to reduce catheter-related infections and other complications.
Study objective
Urinary and (peripheral and central) intravenous catheters are widely used in hospitalized patients, although some serious complications can occur with the use of these catheters. Up to 56% of the catheters do not have an appropriate indication. The main objective of our quality improvement project is to reduce the use of catheters without an appropriate indication by 25-50%.
Study design
The clinical data collection will be once per 14 days during eight months in both the pre- and post-intervention period. The presence and indications for the catheter use will be extracted from medical records in combination with observations of the admitted patients. All other data will be collected from (electronic) medical records and nursing records.
Intervention
First we defined a list of appropriate indications for urinary and (peripheral and central) intravenous catheters, which will restrict the use of catheters and urge catheter removal when the indication is no longer appropriate. Furthermore the intervention consists of a kick-off meeting, including a competitive feedback report of the baseline measurements, and education of healthcare workers and patients.
Additional strategies based on the baseline data and local conditions are optional.
Bart J Laan
Meibergdreef 9
Amsterdam 1105 AZ
The Netherlands
Phone: +31-20-566 6807
b.j.laan@amsterdamumc.nl
Bart J Laan
Meibergdreef 9
Amsterdam 1105 AZ
The Netherlands
Phone: +31-20-566 6807
b.j.laan@amsterdamumc.nl
Inclusion criteria
- Age >18 years old
- Patient admitted to internal medicine or subspecialties (gastroenterology & hepatology, geriatrics, pulmonology and rheumatology), or nonsurgical patient admitted to acute medical units
- Urinary and/or (peripheral and/or central) intravenous catheter
Exclusion criteria
- Patient who had all catheters prior to admission
- Patient admitted for elective short stay
- Terminally ill patient
Design
Recruitment
IPD sharing statement
Followed up by the following (possibly more current) registration
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Other (possibly less up-to-date) registrations in this register
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In other registers
| Register | ID |
|---|---|
| NTR-new | NL5438 |
| NTR-old | NTR6015 |
| Other | the Netherlands Organisation for Health Research and Development (ZonMw) : 8392010022 |