Controlling XXXX associated with intermittent bladder catheterization in geriatric hospitals.

@entity1 @entity281 @entity293
BACKGROUND: Controlling @entity293 ( @entity293 ) associated with intermittent catheterization in geriatric @entity1 . AIM: After a local epidemiological study identified high rates of UTI, a multi-disciplinary working group implemented and evaluated corrective measures. METHODS: In 2009, a one-month prospective study measured the incidence of UTI, controlled for risk factors and exposure, in six geriatric hospitals. In 2010, a self-administered questionnaire on practices was administered to physicians and nurses working in these geriatric units. In 2011, the working group developed a multi-modal programme to: improve understanding of micturition, measurement of bladder volume and indications for catheter drainage; limit available medical devices; and improve prescription and traceability procedures. Detailed training was provided to all personnel on all sites. The epidemiological study was repeated in 2012 to assess the impact of the programme. FINDINGS: Over 1500 @entity1 were included in the 2009 study. The incidence of acquired @entity281 was 4.8%. The @entity281 rate was higher in @entity1 with intermittent catheters than in @entity1 with indwelling catheters (29.7 vs 9.9 UTI per 100 @entity1 , P  =  0.1013) which contradicts the literature. In 2010, the 269 responses to the questionnaire showed that staff did not consider catheterization to place @entity1 at risk of @entity281 , staff had poor knowledge of the recommended indications and techniques, and the equipment varied widely between units. Following implementation of the programme, the study was repeated in 2012 with over 1500 @entity1 . The frequency of UTI in @entity1 with intermittent catheters fell to rates in the published literature. CONCLUSION: Multi-modal programmes are an effective means to control UTI.
