Results after implementation of a protocol on the incidence of urinary tract infection in an intensive care unit.
Anna Letícia Miranda, Ana Lúcia Lyrio de Oliveira, Daiana Terra Nacer and 1 others
PMID 27627125WHAT IT FOUND
UTI incidence density in the ICU fell after catheter protocol implementation, but the drop was not significant.
Urine cultures with more than one organism decreased, and later months showed a downward trend.
Key findings
01UTI incidence density decreased from 13.85 ± 2.07 to 9.88 ± 2.54 after protocol implementation, but the difference was not statistically significant (p = 0.254).
02Urine cultures with more than one microorganism decreased from 53.6% before to 21.1% after protocol implementation, a significant association (p = 0.026).
03The urethral catheter utilization rate did not differ significantly between periods (p = 0.303).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a single-ICU before-and-after study without a control group or random assignment. The primary UTI incidence density reduction was not statistically significant. The sample was small, and the authors state this limits certainty. The implementation month was excluded, so the comparison was not continuous. Results came from records and infection control reporting, and the authors note possible underreporting and weak charting. All patients had indwelling catheters and were ICU patients, so findings may not apply to lower-severity ward patients. The significant result was fewer mixed urine cultures, not a proven reduction in UTI incidence.
The easy way to misread this
Do not conclude that the catheter bundle significantly reduced ICU UTI incidence. The primary incidence density change was not significant, and the significant result was fewer mixed urine cultures.