Interdisciplinary team rounds decreased the number of days patients had urinary catheters and the rate of catheter-associated urinary tract infections at Newark (N.J.) Beth Israel Medical Center, according to a study in the American Journal of Medical Quality.
The hospital implemented daily interdisciplinary team rounds in June 2010. The rounds included an intensive care unit attending physician, ICU fellow physician, ICU charge nurse and ICU nurse assigned to each patient as well as representatives from nutritional services, respiratory therapy, palliative care, hospice and social work. The team met daily to discuss the presence of central venous catheters and indwelling urinary catheters, which were removed if there were no longer indications for their placement or if there were signs of infection.
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From October 2008 to May 2010, before interdisciplinary team rounds were introduced, there were 5,304 indwelling urinary catheter days. From June 2010 to January 2012, after the intervention, this number fell to 4,541. In addition, the CAUTI rate decreased from 4.71 infections per 1,000 ICU days to 1.98 infections per 1,000 ICU days — a reduction of roughly 58 percent.
In contrast, the number of central line days increased after the intervention. However, the catheter-related bloodstream infection rate trended downward. Researchers said possible reasons for the increase in central line days include poorer venous access among patients, a greater need for central line access or increased documentation of central line days as part of the rounds.
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