Authors (including presenting author) :
Lee YCF(1), Leung HY(1), Chung SC(1), Leung SS(1), Li KY(1)
Affiliation :
(1) Community Nursing Service, Princess Margaret Hospital
Introduction :
Catheter-associated urinary tract infections (CAUTI) accounts for up to 30% to 40% healthcare-associated infections in Hong Kong. They are associated with prolonged hospital stay, increased healthcare cost and reduced patient’s quality of life. The risk of infection increases with duration of catheterization that the daily risk of developing CAUTI is 3% to 7%. In community, leakage, blockage, pain and dislodgement of catheters are common problems for community-dwelling patients with long-term urinary catheter. Every year, more than 1000 patients were referred to PMH Community Nursing Service (CNS) for urinary catheter care. Currently, 13% of patients with long-term catheterization under CNS care were suffered from catheter blockage requiring change before due date and 7% were suffered from repeated episodes of urinary tract infection. An evidence-based practice project was hence conducted to explore the use of noble metal alloy (NMA) coated urinary catheter in reducing CAUTI and catheter blockage for community-dwelling patients with long-term urinary catheter.
Objectives :
To evaluate efficacy of NMA coated urinary catheter in reducing episodes of UTI and catheter blockage in community.To identify the evidence-based practice in using the NMA catheter in community
Methodology :
A thorough literature search was conducted according to PICO components of Johns Hopkins Hospital. CINAHL, Cochrane Library, EMBASE, Medline, British Nursing Database and PubMed were searched for English articles from 2014 to 2024. Grey literature search was conducted by performing internet search and reviewing reference lists and bibliographies of retrieved articles. Quality of evidence was appraised using the Johns Hopkins Evidence-Based Practice Model.
Result & Outcome :
Three level I, one level II and one level III evidence were identified. Evidence of three randomized control trials, one prospective study and one retrospective study proved that NMA catheter reduced CAUTI rate and safe without release of any toxic or pharmacological quantities. Since no study explored the effect of NMA catheter for catheter blockage and its usage in community setting before, it is worth to introduce this evidence-based catheter to high-risk group of community-dwelling patients with frequent CAUTI and catheter blockage and conduct a study exploring its efficacy as to improve patient’s quality of life. Finally, barrier was identified in supply-chain logistics as cannot buy in market.
