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The purpose of this study is to determine whether the daily nurse review of the indication of the urinary catheter compared to the everyday care of the working staff is effective to reduce the rate of catheter-associated urinary tract infection in adults hospitalized.
Healthcare-associated infection (HAI)in hospitalized patients are very frequent, especially the catheter-associated urinary tract infection, which prolongs the hospital stay and costs, and is about 3 times more likely to die during hospitalization than patients not infected.
The measures of aseptic insertion and closed systems of collection, as well as the rational use of the probe reduce the risk for infection.
A checklist that contains the agreed indications of catheter, related to obstruction, incontinence, skin lesions in sacral region, monitoring or surgical procedures allows the daily review of the indication of the probe. If the patient doesn´t meet at least one of the criteria, should be recommended the withdrawal of the catheter.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Daily review | Experimental | In the intervention group a nurse reviewed daily, by using a checklist designed for this study, the indications and pertinence of the catheter. If it was not indicated she asked the doctor to order the removal of the catheter, but the doctor would make the final decision. |
|
| Routine care | No Intervention | In the control group, the attending team would remove the catheter as routine, without any suggestion by the research protocol. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Daily review | Other | Daily nursing review of the urinary catheter´s indication. If the patient meets at least one of the entries to stay with bladder catheter, the nurse will record collection in the format but will not contact the health team. If there aren´t indication in the medical record, she contacts at the attending physician and said: "Doctor, I didn´t find record in the history of the indication of the urinary catheter, can we withdraw?. If the physician reported the indication, will be recorded in the format without additional comments. The attending physician decides withdraw or no withdraw the urinary catheter |
| Measure | Description | Time Frame |
|---|---|---|
| Rate of Catheter-associated Urinary Tract Infection | Until 7 days after the withdrawal of the catheter or at discharge (whichever comes first) |
| Measure | Description | Time Frame |
|---|---|---|
| Catheter Days | The duration of catheterization | withdrawal of the catheter |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| MarÃa V Restrepo, Dr. | Hospital Pablo Tobón Uribe | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital Pablo Tobon Uribe | MedellÃn | Antioquia | Colombia |
1.325 patients were assessed for eligibility. 143 were excluded (98 urinary infection and 45 spinal cord injury).
Adult patients hospitalized with indwelling urinary catheters at a tertiary care, 300-bed, teaching hospital in Colombia- South America, were recruitment between November 2009 and May 2010.
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| ID | Title | Description |
|---|---|---|
| FG000 | Daily Review | In the intervention group a nurse reviewed daily, by using a checklist designed for this study, the indications and pertinence of the catheter. If it was not indicated she asked the doctor to order the removal of the catheter, but the doctor would make the final decision. |
| FG001 | Control Group | In the control group, the attending team would remove the catheter as routine, without any suggestion by the research protocol. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Daily Review | In the intervention group a nurse reviewed daily, by using a checklist designed for this study, the indications and pertinence of the catheter. If it was not indicated she asked the doctor to order the removal of the catheter, but the doctor would make the final decision. |
| BG001 |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Median |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Rate of Catheter-associated Urinary Tract Infection | Analysis by intention to treat | Posted | Number | 95% Confidence Interval | infections per 1000 days | Until 7 days after the withdrawal of the catheter or at discharge (whichever comes first) |
|
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Daily Review | In the intervention group a nurse reviewed daily, by using a checklist designed for this study, the indications and pertinence of the catheter. If it was not indicated she asked the doctor to order the removal of the catheter, but the doctor would make the final decision. |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. MarÃa Victoria Restrepo | Hospital Pablo Tobón Uribe | 57-4-4459315 | mrestrepo@hptu.org.co |
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| ID | Term |
|---|---|
| D014552 | Urinary Tract Infections |
| ID | Term |
|---|---|
| D007239 | Infections |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
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|
|
| Control Group |
In the control group, the attending team would remove the catheter as routine, without any suggestion by the research protocol. |
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Diabetes | Diabetes mellitus registered as a personal history or diagnosed on admission | Number | participants |
|
| Kidney failure | Creatinine greater than 2 mg/dL at any time during hospitalization | Number | participants |
|
| Indication of catheter | Number | participants |
|
| Unit placement | Site of insertion of the catheter | Number | participants |
|
| Units |
|---|
| Counts |
|---|
| Participants |
|
|
|
| Secondary | Catheter Days | The duration of catheterization | Analysis by intention to treat | Posted | Median | Inter-Quartile Range | Days | withdrawal of the catheter |
|
|
|
|
| 0 |
| 604 |
| 0 |
| 604 |
| EG001 | Control Group | In the control group, the attending team would remove the catheter as routine, without any suggestion by the research protocol. | 0 | 605 | 0 | 605 |
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| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |