Diagnostic Precision: Exchanging Urinary Catheters Before Urine Specimen Collection to Reduce Catheter-Associated Urinary Tract Infection.

Background: Catheter-associated urinary tract infections are among the most prevalent and costly types of hospital-acquired infections. During the COVID-19 pandemic, growing numbers of critical care patients required indwelling urinary catheters, leading to higher infection rates. Local Problem: A c...

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Publicado en:Critical Care Nurse Vol. 45; no. 2; pp. 25 - 33
Autores principales: Romano, Kathleen, Leone, Jessica, Love, Nora, Caramore, Amy
Formato: algorithm case study tables/charts Journal Article
Publicado: American Association of Critical-Care Nurses Apr2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2025
      vid: 45
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      pub: American Association of Critical-Care Nurses
      place: Alisa Veijo, California
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        10.4037/ccn2025857
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        atl: Diagnostic Precision: Exchanging Urinary Catheters Before Urine Specimen Collection to Reduce Catheter-Associated Urinary Tract Infection.
      aug:
        au:
          Romano, Kathleen
          Leone, Jessica
          Love, Nora
          Caramore, Amy
        affil: Kathleen Romano is a nurse leader in the step-down unit, Memorial Sloan Kettering Cancer Center, New York, New York
      sug:
        subj:
          Catheters, Urinary Adverse Effects
          Catheter Care, Urinary Methods
          Urine Specimen Collection
          Urinary Tract Infections, Catheter-Related Prevention and Control
          Critical Care
          Intensive Care Units Administration
          Hospital Programs
          Program Implementation
          Urinary Tract Infections, Catheter-Related Diagnosis
          Precision
          COVID-19 Pandemic
          Inpatients
          Catheter Care, Urinary Standards
          Frontline Nurses
          Multidisciplinary Care Team
          Protocols
          Medical Practice, Evidence-Based
          Urinalysis
          Quality Improvement
      ab: Background: Catheter-associated urinary tract infections are among the most prevalent and costly types of hospital-acquired infections. During the COVID-19 pandemic, growing numbers of critical care patients required indwelling urinary catheters, leading to higher infection rates. Local Problem: A critical care unit saw a 7-fold increase in the rate of catheter-associated urinary tract infection during the COVID-19 pandemic. A review of procedures showed that the current standard of care for preventing such infections was inadequate. In particular, patients who could not have indwelling urinary catheters promptly removed risked a potential false-positive diagnosis of catheter-associated urinary tract infection due to clinicians' use of long-term catheters to obtain urine specimens for microbiological evaluation. Methods: A literature review was performed to gather evidence on best practices for urine specimen collection in the critical care unit. An interprofessional task force including frontline nurses advocated implementation of a pilot project in 2 critical care units involving exchange of catheters before obtaining urine specimens for microbiological evaluation in any patient who had an indwelling catheter in place for more than 24 hours. Results: Implementation of the new protocol resulted in a major reduction in the diagnosis of catheter-associated urinary tract infection, with no incidents occurring for 2 consecutive quarters. Based on these results, the new evidence-based workflow was incorporated as the standard of care for all adult inpatients. Conclusion: Catheter exchange before collection of urine specimens in patients requiring urine culture evaluation can improve accuracy of diagnosis of catheter-associated urinary tract infection and promote antibiotic stewardship.
      pubtype: Academic Journal
      doctype:
        algorithm
        case study
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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