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This study focuses on evaluating the long-term sustainability of a urinary catheter care bundle designed to prevent urinary tract infections and bladder distension in patients undergoing surgery for hip fractures. The intervention, which included two key innovations-a urinary catheter certificate and a nurse-driven urinary catheter protocol, was implemented between 2015 and 2020 and successfully reduced urinary tract infections and bladder distension, previously published. However, due to the pandemic, the initiative was paused and had to be reintroduced in 2022. Now, the study aims to assess the effectiveness of these preventive measures 9 years after their initial implementation. The research will analyze changes in the incidence of urinary tract infections, bladder distension, catheterisation methods, and documentation practices in patients aged 65 and older. The findings will help inform healthcare policies and may have broader implications for preventing adverse events in other surgical patient groups
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients undergoing hip fracture surgery year nine after the intervention started. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Safe Hands and Safe Bladder intervention | Behavioral | Evaluating changes in urinary tract infections and bladder distension nine-year after implementing preventive measures |
|
| Measure | Description | Time Frame |
|---|---|---|
| Describe changes in the incidence of in-hospital urinary catheter-associated infections; Year 9 will be compared with previously published data from Years 1-5 | Definition: Urinary tract infection with onset on day 3 after admission with prior urinary catheterisation. A physician prescribed antimicrobial agents for a urinary tract infection during the hospital stay. Data will be collected from patients' medical records. Logistic regression analysis will be performed | For one year |
| Measure | Description | Time Frame |
|---|---|---|
| Changes in the incidence of in-hospital acquired bladder distension will be compared; Year 9 will be compared to previously published data from Years 1-5. | Definition: Bladder distension is defined according to the national marker for point prevalence measurement when assessing adverse events. Bladderscan volume from patients' medical records. | For one year. |
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Inclusion Criteria:
-Hip fracture surgery at the study site, age 65 years and older and cared for in the ortho-geriatric wards.
Exclusion Criteria:
-No catheterisation during hospital stay
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Patients aged 65 years and older undergoing hip fracture surgery at a university hospital in Sweden.
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| Name | Affiliation | Role |
|---|---|---|
| Annette Erichsen, Associate Professor | Gothenburg University, Sahlgrenska University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sahlgrenska Academy, Sahlgrenska University hospital/Mölndal | Mölndal | Västra Götaland County | 43180 | Sweden |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36064457 | Background | Erichsen Andersson A, Gillespie BM, Karlsson M, Malchau H, Nellgard B, Wikstrom E, Rogmark C, Tillander J. Reduction of early surgical site and other care related infections in 3553 hip fracture patients: lessons learned from the 5-year Safe Hands project. Antimicrob Resist Infect Control. 2022 Sep 5;11(1):113. doi: 10.1186/s13756-022-01153-4. | |
| 30449454 |
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| Changes in urine volume of 500ml and more during hospital stay. Year nine will be compared yera 1-5, previous published data | Bladderscan volume from patients' medical records. | For one year |
| Changes in catheterization methods during the hospital stay will be compared, with data from Year 9 compared to previously published data from Years 1-5 | Data will be collected from patients' medical records. | For one year |
| Changes in urinary catheter-related documentation in Year 9 will be compared to previously published data from Years 1-5. | Catheter-related documentation will be collected from patients' medical records. | For one year |
| Wikstrom E, Dellenborg L, Wallin L, Gillespie BM, Erichsen Andersson A. The Safe Hands Study: Implementing aseptic techniques in the operating room: Facilitating mechanisms for contextual negotiation and collective action. Am J Infect Control. 2019 Mar;47(3):251-257. doi: 10.1016/j.ajic.2018.08.024. Epub 2018 Nov 16. |
| 29301519 | Background | Erichsen Andersson A, Frodin M, Dellenborg L, Wallin L, Hok J, Gillespie BM, Wikstrom E. Iterative co-creation for improved hand hygiene and aseptic techniques in the operating room: experiences from the safe hands study. BMC Health Serv Res. 2018 Jan 4;18(1):2. doi: 10.1186/s12913-017-2783-1. |
| 36224550 | Background | Frodin M, Nellgard B, Rogmark C, Gillespie BM, Wikstrom E, Andersson AE. A co-created nurse-driven catheterisation protocol can reduce bladder distension in acute hip fracture patients - results from a longitudinal observational study. BMC Nurs. 2022 Oct 12;21(1):276. doi: 10.1186/s12912-022-01057-z. |
| 35340925 | Background | Frodin M, Ahlstrom L, Gillespie BM, Rogmark C, Nellgard B, Wikstrom E, Erichsen Andersson A. Effectiveness of implementing a preventive urinary catheter care bundle in hip fracture patients. J Infect Prev. 2022 Mar;23(2):41-48. doi: 10.1177/17571774211060417. Epub 2022 Feb 15. |
| ID | Term |
|---|---|
| D016055 | Urinary Retention |
| D006620 | Hip Fractures |
| D014552 | Urinary Tract Infections |
| ID | Term |
|---|---|
| D014555 | Urination Disorders |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D005264 | Femoral Fractures |
| D050723 | Fractures, Bone |
| D014947 | Wounds and Injuries |
| D025981 | Hip Injuries |
| D007869 | Leg Injuries |
| D007239 | Infections |
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