Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

A Retrospective, Observational Study of Catheter-associated Urinary Tract Infection Events Post-implementation of a Novel Urinary Catheter System with Active Drain Line Clearance and Automated Intra-abdominal Pressure Monitoring

Version 1 : Received: 28 September 2022 / Approved: 30 September 2022 / Online: 30 September 2022 (04:13:24 CEST)

A peer-reviewed article of this Preprint also exists.

Brockway, P.; Hill, D.M.; Moll, V.; Stanton, K.; Malbrain, M.L.N.G.; Velamuri, S.R. A Retrospective, Observational Study of Catheter-Associated Urinary Tract Infection Events Post-Implementation of a Novel Urinary Catheter System with Active Drain Line Clearance and Automated Intra-Abdominal Pressure Monitoring. Life 2022, 12, 1950. Brockway, P.; Hill, D.M.; Moll, V.; Stanton, K.; Malbrain, M.L.N.G.; Velamuri, S.R. A Retrospective, Observational Study of Catheter-Associated Urinary Tract Infection Events Post-Implementation of a Novel Urinary Catheter System with Active Drain Line Clearance and Automated Intra-Abdominal Pressure Monitoring. Life 2022, 12, 1950.

Abstract

OBJECTIVE A quality improvement study to assess catheter-associated urinary tract infection (CAUTI) rate post-implementation of a bladder catheter with integrated active drain line urine clearance and automated intra-abdominal pressure monitoring in a burn intensive care unit (ICU). DESIGN Eight-year retrospective before and after study (2015–2022). SETTING A single American Burn Association verified Burn Center with fourteen inpatient beds. PATIENTS Patients meeting criteria for admission to a Burn Center METHODS Retrospective cohort study following the implementation of a novel urine output monitoring system with integrated drain line and urine clearance. Data from a 48-month (from January 2015-December 2018) historical control (period 1) were compared to data from a 28-month (from January 2020 to April 2022) post-implementation period (period 2). Pre- and post-implementation CAUTI event incidences were compared. Charts were reviewed to characterize the patients. RESULTS A total of 42 CAUTIs in 2243 patients were identified using the National Health and Safety Network (NHSN) definition during the analyzed period. There were 40 CAUTI events in period 1 and two CAUTIs in period 2. The incidence of CAUTI events pre-implementation was 0.030 (mean of 10 CAUTI events per year) compared to 0.002 (mean of 1 CAUTI event per year) post-implementation of an automatic drain line clearing UO monitoring system showing a significant reduction in CAUTI events (P<0.01, risk ratio novel vs. gravity bladder catheter 0.071, 95% confidence interval: 0.017-0.294). CONCLUSIONS CAUTIs were reduced in the period following the implementation of a novel urinary catheter system with an integrated active drain line and urine clearance in burn patients.

Keywords

catheter-associated infection; CAUTI; urinary tract infection; healthcare-associated infection; active drain line clearance; burns; intra-abdominal pressure; measurement

Subject

Medicine and Pharmacology, Urology and Nephrology

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