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Housestaff knowledge, application of CAUTI guidelines fall short
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Hospital housestaff knowledge and their application of guidelines related to catheter-associated urinary tract infections fell short of national goals, according to researchers from Massachusetts General Hospital.
In the study, the researchers surveyed 403 hospital housestaff in medicine, surgery, pediatrics, anesthesia and emergency medicine at their hospital, assessing participants’ knowledge of catheter-associated urinary tract infection (CAUTI) risk factors and prevention guidelines. This staff, and often housestaff at other teaching hospitals, are responsible for ordering catheter placement and discontinuation.
The survey inquired about the frequency with which housestaff re-evaluated the need for catheter placement in patients. Respondents were presented with clinical scenarios and asked to identify the appropriate indications for catheter placement and timing for their postoperative removal.
Of the staff who participated in the survey, 158 returned complete responses. Twenty-seven percent were postgraduate year (PGY)1, 32% were PGY2, and 41% were PGY3 and higher.
Sixty percent of housestaff reported being aware of CAUTI prevention guidelines. By PGY level, the researchers found that 44% of PGY1 residents claimed to have an awareness of the guidelines vs. 70% of those who were PGY3 or higher (P = .007).
Almost 90% of participants correctly identified the duration of catheter placement as the greatest risk factor for the development of CAUTI. However, only 54% correctly specified the daily risk for CAUTI per catheter-day, with no statistical difference seen between PGY levels.
Eleven percent of participants said it was easy to find written evidence of the presence of a urinary catheter, while 29% reported that finding such documentation was difficult or very difficult. Approximately half of respondents reported that nursing notes were the most likely place to find documentation of a catheter. According to the researchers, 46% of housestaff reported at least daily reassessment of the need for catheter placement in patients.
“Because reducing CAUTIs is a health care priority, targeted interventions, including educational initiatives, need to be developed and aimed at housestaff who can play a major role in decreasing catheter use and duration.” – by Jen Byrne
Disclosure: The researchers report no relevant financial disclosures.
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