A Model for Prevention of Urinary Tract Infection in Patients with Indwelling Catheter, Kosum Phisai Hospital

Abstract

The objective of this study was to develop a model to prevent and reduce urinary tract infection in patients with indwelling catheter. It was conducted in Kosum Phisai Hospital, Mahasarakham Province, Thailand, using targeted surveillance for hospital-acquired infection and a model developed by the author. The study was conducted in 2009 and 2010 in 3 phases. The phase 1 was an assessment of the catheterization procedures and flush technique using the hospital surveillance forms; the phase 2 was to study and to develop management and care guidelines for patients requiring urinary catheterization; and phase 3 was to monitor and empower patients and family care takers regarding the care for the patients with indwelling catheter. Data were collected by a researcher, which include observation and assessment records as well as reports on urinary tract infections. It was found that before the development and implementation of the model, the trend of urinary tract infection in patients with indwelling catheter was increasing to reach 25.8 times/1000 cath-days in 2008. Catheterization and flush technique were not conducted correctly; and insufficient guidance provided to patients and relatives. After the phase 2 implementation, it was observed that all nurses correctly performed catheterization and flush in accordance with the 20-item guideline resulting in the decline of urinary tract infection. Finally, with the implementation of the 12-item guideline for patients and their relatives developed in the phase 3, the situation of urinary tract infection was under control. There was no new incidence in patients with indwelling catheter during the years 2009-2010. The model had become a common practice in Kosum Phisai Hospital. Monthly report and review were routinely conducted by the Infection Control Committee and the Executive Committee of the Hospital to monitor the situation on urinary tract infections in patients with indwelling catheter.