AN INTERVENTIONAL STUDY TO IMPROVE THE EMERGENCY DEPARTMENT CATHETER ASSOCIATED URINARY TRACT INFECTION: EVIDENCE FROM A TERTIARY CENTER

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Yoon Chin Yap
Mohd Idzwan Bin Zakaria
Sasheela A/P Sri La Ponnampalavanar
Maria Kahar Bador Binti Abdul Kahar

Abstract

Background: The Emergency Department (ED) is the major entry point for patients admitted into the hospital. The continued use of urinary catheters from the ED is identified as a risk for patients to develop catheter associated urinary tract infection (CAUTI).


Objective: This study aimed firstly to identify the prevalence of ED-related CAUTI in our centre, University Malaya Medical Centre and the appropriateness of catheter use among all the cases. Secondly, to assess the impact of a urinary catheter care bundle E-learning training module on the rates of CAUTI and appropriate use of urinary catheter.


Method: A pre-post intervention study was conducted between June 2017 and April 2019. A retrospective analysis was conducted to assess the changes in infection rate before and after the training module. The urinary care bundle E learning tutorial module was developed, and all ED staff were trained using this module from September 2018 to November 2018. Outcome measures were the prevalence rate of ED-related CAUTI, the rate of appropriateness indication in urinary catheter insertion and the association between patient’s characteristic and the rate of appropriateness in urinary catheterization.


Result: The CAUTI rates were significantly dropped from 17.04 per 1000 device days in pre-intervention period to 7.4 in post-intervention period (p=0.03).


Conclusion: An online training module on urinary catheter bundle effectively reduced CAUTIs but not improve the appropriate use of urinary catheter. Therefore, further study is needed to improve the rate of appropriateness in urinary catheter insertion.

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Research article
Author Biographies

Mohd Idzwan Bin Zakaria, Academic Unit Trauma and Emergency Department, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia

Associate Professor and Senior Consultant Emergency Physician and Lecturer, Faculty of Medicine, University of Malaya, Jalan Universiti 50603, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia

Sasheela A/P Sri La Ponnampalavanar, Department of Infection Disease, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia

Associate Professor and Consultant Infectious Diseases Physician, Faculty of Medicine , University of Malaya, Jalan Universiti 50603, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia.

Maria Kahar Bador Binti Abdul Kahar, Department of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Jalan Universiti 50603, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia

Clinical Microbiologist and Senior Lecturer,. Faculty of Medicine , University of Malaya, Jalan Universiti 50603, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia