Nursing protocols to reduce urinary tract infection caused by indwelling catheters: an integrative review.
Maria Estela de Queiroz Miranda, Marcelo Ricardo Rosa, Meire Cristina Novelli E Castro and 2 others
PMID 36888796WHAT IT FOUND
Nurse-driven catheter protocols were associated with lower catheter-associated UTI rates in some US ICU studies.
One study reported a reduction from 5.1 to 2.0 infections per 1,000 catheter-days, but evidence was limited.
Key findings
01Three nurse-directed protocols were associated with lower catheter-associated UTI rates in adult and older ICU patients, but the evidence was limited to US ICU observational studies.
02One protocol reported a reduction from 5.1 to 2.0 infections per 1,000 catheter-days, while another reported a 19% overall reduction that was not statistically significant (p = 0.13).
03A third protocol reported a median catheter-associated UTI drop from 10.31 to 0.00 with 91% nurse compliance, but catheter days did not significantly differ.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The review included only three articles, all from United States intensive care units. All included studies were observational level IV designs, not randomized trials. The protocols bundled several nursing actions, so the effect of any single step cannot be separated. Results were inconsistent: one multi-hospital study had a 19% overall reduction that was not statistically significant (p = 0.13), and hospital outcomes varied. In the study with the largest reduction, catheter days did not significantly change despite the UTI rate falling. Nurse compliance varied and was reported as important.
The easy way to misread this
Do not read the drop to zero infections as proof that nurse protocols always prevent catheter-associated UTI. The review had only three US ICU observational studies, one study's 19% reduction was not statistically significant (p = 0.13), and catheter days did not significantly change in another.