Reduce the inappropriate use of urinary catheters and intravenous (IV) catheters

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.

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%.

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.

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.