Novel low-resource intervention reduces urinary catheter use and associated XXXX : Role of outcome measure bias?

@entity1 @entity1212 @entity293 @entity580
BACKGROUND: Previous interventions targeting nosocomial @entity293 have reduced catheterization and infections, but they require significant resources and may be susceptible to misclassification and surveillance bias. We sought to determine the effectiveness of a novel intervention at reducing catheterization and infections while exploring the potential for bias. METHODS: We conducted a prospective study of a brief monthly in- @entity1 educational intervention focusing on appropriate urinary catheter use. RESULTS: We studied 1,335 @entity1 (13,753 @entity1 days) on 1 control and 1 intervention ward. After the intervention, the device utilization rate was significantly reduced, with a relative risk of 0.49 (95% confidence interval [CI], 0.32-0.76; P  =  .001) versus 1.02 (95% CI, 0.58-1.82; P  =  .93) for controls. Both wards demonstrated a reduction in @entity1212 after intervention, with an intervention relative risk of 0.42 (95% CI, 0.16-1.08; P  =  .07) and 0.51 (95% CI, 0.22-1.20; P  =  .12) for controls. There was no change in the rate of all nosocomial urine infections, with an intervention relative risk of 0.79 (95% CI, 0.38-1.65; P  =  .53) and 0.89 (95% CI, 0.48-1.67; P  =  .72) for controls. CONCLUSION: Our study demonstrates that our novel educational intervention significantly reduces urinary catheter use in hospitalized @entity1 . The trend towards reduced @entity1212 after intervention, coupled with the absence of an improvement in all @entity580 supports a potential role of misclassification bias. We suggest that future prospective investigations explore this phenomenon using more robust outcome measures.
