UTI Care at Hospitals Lacking

Urinary tract infection policies lacking amongst larger hospitals

(RxWiki News) Hospitalized patients often have urinary catheters placed if they are unable to go to the bathroom on their own. But be wary of the care that is given to these catheters.  

New research shows that across the US, little attention is given to policies that prevent urinary tract infections (UTI) in the intensive care units of hospitals.

According to researchers, health personnel “should implement policies aimed at limiting unnecessary catheter use and shortening the duration of catheterization at their institutions."

"Ask about all your procedures while hospitalized."

Abnormal-looking or smelling urine and the urge to go too often characterize urinary tract infections, which are the most common bacterial infections in the US.

The study, led by Laurie Conway, RN, from the Columbia University School of Nursing, surveyed 441 hospitals in 2008 on the quality and effectiveness of their infection control practices concerning UTIs.

Hospitals were part of the National Healthcare Safety Network. The network sends information on infections related to the health care place.

Researchers gathered information from 250 hospitals that voluntarily provided information for more than 400 ICUs.

They looked into the number and roles of the professional staff, whether they were board certified and how many hours were dedicated to the department.

The quality of the facilities and ICU department were also accounted for, as well as whether the organization had support from important decision makers and surveillance systems.

They also looked into whether hospitals had policies addressing UTIs from catheters and if the policies were actually being followed.

Researchers found that larger hospitals with more than 500 beds were half as likely as smaller hospitals to have some policy that prevents UTIs caused by catheters.

Two-thirds of the hospitals don't know how many patient UTIs were caused by their catheters.

Hospitals where infection control directors have a lot of say in decision making are twice as likely to adopt a UTI prevention policy compared to hospitals where directors have less control.

Of the ICUs surveyed, 26 percent have policies that support bladder ultrasounds.

In addition, 20 percent support condom catheters, 12 percent used reminders in their facilities to remove catheters and 10 percent had nurses in charge of removing the catheters.

"These guidelines all point to one overriding principle: minimize unnecessary urinary catheter use," the authors said in their report.

"Many of the strategies advocated in the guidelines support this principle, including substituting condom catheters for indwelling catheters; using bladder ultrasound scanners to identify or rule out urinary retention."

Future research, the authors say, should find how UTI prevention policies affect the number of UTIs in hospitals.

The authors note that the results may be skewed since the hospitals included in their study were larger on average compared to the rest of the country, and they didn't get information from hospitals that didn't volunteer their information.

National Institute of Nursing Research supported the study. The authors report no conflicts of interest. The study was published in the October 2012 issue of the American Journal of Infection Control.

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Review Date: 
November 3, 2012