Tag Archives: urinary catheter

What product do you use prior to urinary catheter insertion?

There is conflicting evidence and hence variation in practice, on which solution you should use for meatal cleaning prior to urinary catheter insertion. A systematic review demonstrates the variation in evidence.

Which do you use in your hospital or clinical practice?

You can vote using the poll below. The results will form part of the discussion in a talk at the IPS conference and ACIPC conference.

So, which is correct?

Well, we will soon be able to tell you whether chlorhexidine or saline is better (or no difference) at reducing CAUTI and asymptomatic bacteriuria. We have undertaken a RCT in three hospitals, involving hundreds of patients and catheter insertions. The aim is to determine the effectiveness and cost effectiveness of chlorhexidine vs saline. The outcomes are asymptomatic bacteriuria and CAUTI.

Data collection was completed earlier this year and analysis is also nearing completion.

Some preliminary results will be presented at the IPS conference in Glasgow in October and more detailed results at the ACIPC conference in Brisbane and HIS conference in Liverpool (England).

I would like to thank the participating hospitals – Canberra hospital, Sydney Adventist Hospital and Lismore hospital.

More to come on this, so stay tuned. The results, regardless of what they are, will help shape guidelines and clinical practice internationally.

Brett

Researcher team: Prof Brett Mitchell, Dr Oyebola Fasugba, Dr Anne Gardner, Dr Jane Koerner, Prof Peter Collignon, Prof Allen Cheng, Prof Nick Graves, Mrs Vicky Gregory (Project Manager)

Funding: This project is supported a grant from the HCF Foundation, a nationally competitive grant.

References

Fasugba, O., Koerner, J., Mitchell, B. G., & Gardner, A. (2017). Systematic review and meta-analysis of the effectiveness of antiseptic agents for meatal cleaning in the prevention of catheter-associated urinary tract infections. Journal of Hospital Infection, 95(3), 233-242.

Mitchell, B. G., Fasugba, O., Gardner, A., Koerner, J., Collignon, P., Cheng, A. C., … & Gregory, V. (2017). Reducing catheter-associated urinary tract infections in hospitals: study protocol for a multi-site randomised controlled study. BMJ open, 7(11), e018871.
Chicago.

 

Reducing urinary catheter use

One of the ways  to reduce the risk of catheter associated urinary tract infection (CAUTI) is to reduce catheter duration. Evidence has shown the value of stop orders and reminders (to remove the catheter ASAP) at reducing the incidence of CAUTI.

We have finished a RCT  in an Australian hospital, exploring the effect of an electronic reminder, attached to a catheter bag, on reducing catheter duration. We also surveyed nurses and undertook a focus group.

I’m looking forward to presenting results at the IPS conference in Glasgow and ACIPC later in the year in Australia. 

 

Researchers: Mitchell, BG., Fasugba, O., Russo, P., Cheng, A., Northcote, M. (Hannah Rosebrock, Research Officer).

Funding: This study was supported by an Commonwealth government commercialisation grant.

References

Meddings, J., Rogers, M. A., Krein, S. L., Fakih, M. G., Olmsted, R. N., & Saint, S. (2014). Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review. BMJ Qual saf, 23(4), 277-289.