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      Healthcare providers' compliance with guidelines for catheter-associated urinary tract infections in a rural teaching and referral hospital Translated title: Cumplimiento de las pautas para las infecciones del tracto urinario asociadas con el catéter por parte de los proveedores de atención médica en un hospital rural docente y de referencia

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          Abstract

          Abstract Introduction: Healthcare professionals (HCPs) play a key role in the prevention of catheter-associated urinary tract infections (CAUTI). This study aims to determine the compliance of healthcare personnel with urethral catheterisation standards and the factors affecting it. Materials and Methods: This study is a prospective survey and was conducted between February and March 2021 after ethical approval and patient consent. An internet-based, structured 39-item questionnaire was sent via email to all HCPs at Zonguldak Bulent Ecevit University Hospital, Zonguldak, Turkey. A to evaluate their knowledge and attitudes towards the prevention of CAUTI. The questionnaire was completed by 156 health professionals. For categorical parameters Fisher’s exact test, though for scale parameters student t-test, Mann–Whitney U and Kruskal–Wallis tests were used. All statistical analysis was done using SPSS 17.0. Results: The average years of experience of the HCPs who participated in the survey was 12.5 years. The level of knowledge of the doctors and the nurses about the indication of catheter insertion was similar, whereas the level of knowledge about CAUTI prevention was higher among the doctors. However, none of the participants could fully describe how to prevent CAUTI. Conclusions: The level of knowledge of CAUTI preventive measures among the participants was insufficient. To effectively preventing CAUTI, there is a need to change HCPs’ perspective on this issue, which can be achieved through training, and advantage current technologies.

          Translated abstract

          Resumen Introducción: Los profesionales de la salud (PS) juegan un papel clave en la prevención de infecciones del tracto urinario asociadas al catéter (ITUAC). Este estudio tiene como objetivo determinar el cumplimiento de las normas de sondaje uretral por parte del personal sanitario y los factores que lo afectan. Materiales y métodos: Este estudio es una encuesta prospectiva y se realizó entre febrero y marzo de 2021 después de la aprobación ética y el consentimiento del paciente. Se envió un cuestionario estructurado de 39 ítems basado en Internet por correo electrónico a todos los HCP en el Hospital Universitario Zonguldak Bulent Ecevit, Zonguldak, Turquía. A para evaluar sus conocimientos y actitudes hacia la prevención de la ITUAC. El cuestionario fue completado por 156 profesionales de la salud. Para los parámetros categóricos se utilizó la prueba exacta de Fisher, aunque para los parámetros de escala se utilizaron la prueba t de Student, la U de Mann-Whitney y la de Kruskal-Wallis. Todos los análisis estadísticos se realizaron con SPSS 17.0. Resultados: El promedio de años de experiencia de los profesionales de la salud que participaron en la encuesta fue de 12,5 años. El nivel de conocimiento de los médicos y las enfermeras sobre la indicación de la inserción del catéter fue similar, mientras que el nivel de conocimiento sobre la prevención de las ITUAC fue mayor entre los médicos. Sin embargo, ninguno de los participantes pudo describir completamente cómo prevenir ITUAC. Conclusiones: El nivel de conocimiento de las medidas preventivas de ITUAC entre los participantes fue insuficiente. Para prevenir CAUTI de manera efectiva, es necesario cambiar la perspectiva de los profesionales de la salud sobre este tema, lo que se puede lograr a través de la capacitación y aprovechar las tecnologías actuales.

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          Diagnosis, Prevention, and Treatment of Catheter-Associated Urinary Tract Infection in Adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America

          Guidelines for the diagnosis, prevention, and management of persons with catheter-associated urinary tract infection (CA-UTI), both symptomatic and asymptomatic, were prepared by an Expert Panel of the Infectious Diseases Society of America. The evidence-based guidelines encompass diagnostic criteria, strategies to reduce the risk of CA-UTIs, strategies that have not been found to reduce the incidence of urinary infections, and management strategies for patients with catheter-associated asymptomatic bacteriuria or symptomatic urinary tract infection. These guidelines are intended for use by physicians in all medical specialties who perform direct patient care, with an emphasis on the care of patients in hospitals and long-term care facilities.
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            Preventing hospital-acquired urinary tract infection in the United States: a national study.

            Although urinary tract infection (UTI) is the most common hospital-acquired infection in the United States, to our knowledge, no national data exist describing what hospitals in the United States are doing to prevent this patient safety problem. We conducted a national study to examine the current practices used by hospitals to prevent hospital-acquired UTI. We mailed written surveys to infection control coordinators at a national random sample of nonfederal US hospitals with an intensive care unit and >or=50 hospital beds (n=600) and to all Veterans Affairs (VA) hospitals (n=119). The survey asked about practices to prevent hospital-acquired UTI and other device-associated infections. The response rate was 72%. Overall, 56% of hospitals did not have a system for monitoring which patients had urinary catheters placed, and 74% did not monitor catheter duration. Thirty percent of hospitals reported regularly using antimicrobial urinary catheters and portable bladder scanners; 14% used condom catheters, and 9% used catheter reminders. VA hospitals were more likely than non-VA hospitals to use portable bladder scanners (49% vs. 29%; P=.001), condom catheters (46% vs. 12%; P=.001), and suprapubic catheters (22% vs. 9%; P=.001); non-VA hospitals were more likely to use antimicrobial urinary catheters (30% vs. 14%; P=.001). Despite the strong link between urinary catheters and subsequent UTI, we found no strategy that appeared to be widely used to prevent hospital-acquired UTI. The most commonly used practices--bladder ultrasound and antimicrobial catheters--were each used in fewer than one-third of hospitals, and urinary catheter reminders, which have proven benefits, were used in <10% of US hospitals.
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              A multicenter qualitative study on preventing hospital-acquired urinary tract infection in US hospitals.

              Although urinary tract infection (UTI) is the most common hospital-acquired infection, there is little information about why hospitals use or do not use a range of available preventive practices. We thus conducted a multicenter study to understand better how US hospitals approach the prevention of hospital-acquired UTI. This research is part of a larger study employing both quantitative and qualitative methods. The qualitative phase consisted of 38 semistructured phone interviews with key personnel at 14 purposefully sampled US hospitals and 39 in-person interviews at 5 of those 14 hospitals, to identify recurrent and unifying themes that characterize how hospitals have addressed hospital-acquired UTI. Four recurrent themes emerged from our study data. First, although preventing hospital-acquired UTI was a low priority for most hospitals, there was substantial recognition of the value of early removal of a urinary catheter for patients. Second, those hospitals that made UTI prevention a high priority also focused on noninfectious complications and had committed advocates, or "champions," who facilitated prevention activities. Third, hospital-specific pilot studies were important in deciding whether or not to use devices such as antimicrobial-impregnated catheters. Finally, external forces, such as public reporting, influenced UTI surveillance and infection prevention activities. Clinicians and policy makers can use our findings to develop initiatives that, for example, use a champion to promote the removal of unnecessary urinary catheters or exploit external forces, such public reporting, to enhance patient safety.
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                Author and article information

                Journal
                ijm
                Iberoamerican Journal of Medicine
                Iberoam J Med
                Hospital San Pedro (Logroño, La Rioja, Spain )
                2695-5075
                2695-5075
                2022
                : 4
                : 4
                : 199-205
                Affiliations
                [1] orgnameZonguldak Bulent Ecevit University Hospital orgdiv1Department of Urology Turquía
                [2] orgnameZonguldak Bulent Ecevit University Hospital orgdiv1Department of Infectious Diseases Turquía
                Article
                S2695-50752022000400005 S2695-5075(22)00400400005
                10.53986/ibjm.2022.0036
                27455aa4-a29b-4294-a040-f3e61e968fa9

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 06 July 2022
                : 02 September 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 17, Pages: 7
                Product

                SciELO Spain

                Categories
                Original Article

                Urinary tract infection,Prevención,Catheter,Health personnel,Knowledge,Prevention,Infecciones del tracto urinario,Catéter,Personal sanitario,Conocimiento

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