Reduction of Inappropriate Urinary Catheter Use at a Veterans Affairs Hospital Through a Multifaceted Quality Improvement Project

摘要: Background Foley catheter (FC) use is a modifiable risk factor for hospital-acquired urinary tract infection, the most common type of nosocomial infection. It unknown whether sustained, hospital-wide reductions in FC are achievable by combining interventions with demonstrated short-term effectiveness selected units. Methods A multifaceted quality improvement project to decrease unnecessary and increase order documentation was instituted throughout Minneapolis Veterans Affairs Medical Center March 2005, after >2-year baseline period. Bundled included multiple types education, system redesign, rewards, feedback (phases I II), plus, phase III, involvement dedicated nurse. Results The daily prevalence dropped steeply during intervention (5.5 months), from 15.2% mean 9.3% nadir, but rebounded quickly subsequent hiatus (1.2 months). again (mean, 13.6%) II (27.3 months) even further 12.0%) III (22.8 (P ≤ .001, or vs baseline). Compared baseline, (with nurse) percentages nonordered nonindicated FCs 17% 5.1% 15% 1.2%, respectively. During phases combined, an estimated total 6691 days were avoided. Conclusions Significant inappropriate improved achieved through multicomponent campaign. greatest sustained improvements accompanied