【AIM2012】Reducing Inappropriate Urinary Catheter Use
本帖最后由 蓝鱼o_0 于 2012-6-1 00:23 编辑Background: Indwelling urinary catheters may lead to
both infectious and noninfectious complications and are
often used in the hospital setting without an appropriate
indication. The objective of this study was to evaluate
the results of a statewide quality improvement effort
to reduce inappropriate urinary catheter use.
Methods: Retrospective analysis of data collected between
2007 and 2010 as part of a statewide collaborative
initiative before, during, and after an educational intervention
promoting adherence to appropriate urinary
catheter indications. The data were collected from 163
inpatient units in 71 participating Michigan hospitals. The
intervention consisted of educating clinicians about the
appropriate indications for urinary catheter use and promoting
the daily assessment of urinary catheter necessity
during daily nursing rounds. The main outcome measures
were change in prevalence of urinary catheter use
and adherence to appropriate indications. We used flexible
generalized estimating equation (GEE) and multilevel
methods to estimate rates over time while accounting
for the clustering of patients within hospital units.
Results: The urinary catheter use rate decreased from
18.1% (95% CI, 16.8%-19.6%) at baseline to 13.8% (95%
CI, 12.9%-14.8%) at end of year 2 (P.001). The proportion
of catheterized patients with appropriate indications
increased from 44.3% (95% CI, 40.3%-48.4%) to 57.6%
(95% CI, 51.7%-63.4%) by the end of year 2 (P=.005).
Conclusions: A statewide effort to reduce inappropriate
urinary catheter use was associated with a significant
reduction in catheter use and improved compliance
with appropriate use. The effect of the intervention
was sustained for at least 2 years.
Arch Intern Med.
Published online January 9, 2012.
doi:10.1001/archinternmed.2011.627
影响因子：9.8.
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