EFFECT OF EDUCATION AND PERFORMANCE FEEDBACK ON RATES OF CATHETER ASSOCIATED URINARY TRACT INFECTION IN INTENSIVE CARE UNITS IN ARGENTINA
ABSTRACT
OBJECTIVE:To evaluate the effect of education and performance feedback regarding compliance with catheter care and
handwashing on rates of catheter-associated urinary tract infection (UTI) in intensive care units (ICUs).
SETTING : Two level III adult ICUs in a private healthcare facility in Argentina .
PATIENTS:All adult patients admitted to the study units who had a urinary catheter in place for at least 24 hours.
METHODS: A prospective, open trial in which rates of catheter-associated UTI determined during a baseline period of
active surveillance without education and performance feedback were compared with rates of catheter-associated UTI after implementing education and performance feedback.
RESULTS: There were 1,779 catheter-days during the baseline period and 5,568 catheter-days during the intervention
period. Compliance regarding prevention of compression of the tubing by a leg improved (from 83% to 96% ; relative risk
[RR], 1 .15 ; 95% confidence interval [CI 95], 1 .03 to 1 .28; P =.01) and so did compliance with handwashing (from 23 .1% to 65 .2% ; RR, 2 .82 ;CI96 , 2 .49 to 3 .20 ; P <.0001) . Catheter-associated UTI rates decreased significantly from 21.3 to 12 .39 per 1,000 catheter-days(RR, 0 .58 ; Cl 95,0.39 to 0.86 ; P = .006) .
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