Effectiveness of implementing a preventive urinary catheter care bundle in hip fracture patients. Issue 2 (March 2022)

• Record Type: Journal Article
• Authors: Frödin, Maria; Ahlstrom, Linda; Gillespie, Brigid M.; Rogmark, Cecilia; Nellgård, Bengt; Wikström, Ewa; Erichsen Andersson, Annette
• Is Part Of: Journal of infection prevention. Volume 23:Issue 2(2022)
• Page Start: 41
• Page End: 48
• Publication Date: 2022-03
• Subjects: Infection prevention -- implementation -- bundle intervention -- acute hip fracture -- catheter associated urinary tract infection; Hospital buildings -- Sanitation -- Periodicals; Communicable diseases -- Prevention -- Periodicals; Nosocomial infections -- Prevention -- Periodicals; Cross infection -- Prevention -- Periodicals; 616.9045
• DOI: 10.1177/17571774211060417
• Languages: English
• ISSNs: 1757-1774

Abstract

Background: Urinary catheter (UC)–associated infections are one of the most common preventable healthcare-associated infections (HAIs) and they frequently occur in older, frail populations. Aim: The study aim was to describe the incidence of UC-associated infection in elderly patients undergoing hip fracture surgery after implementing a preventive care bundle. Methods: A longitudinal prospective study using a before-and-after design. The bundle was theory driven and involved the co-creation of a standard operational procedure, education and practical training sessions. Prospectively collected registry data were analysed. Univariable statistics and multivariable logistic regressions were used for analyses. Results: 2, 408 patients with an acute hip fracture were included into the study. There was an overall reduction in UC catheter associated-associated urinary tract infections, from 18.5% ( n = 75/406) over time to 4.2% ( n = 27/647). When adjusting for all identified confounders, patients in phase 4 were 74% less likely to contract an UC-associated infection (OR, 0.26; 95% CI, 0.15–0.45, p < 0.0001). Discussion: Bundled interventions can reduce UC-associated infections substantially, even in elderly frail patients. Partnership and co-creation as implementation strategies appear to be promising in the fight against HAI.