Effects of Constipation Management Alert Combined with Catheter Removal on Urinary Tract Infection Among Critical Neurosurgical Patients
Keywords:
Constipation alert, catheter associated urinary tract infection, critical neurosurgical patientsAbstract
The purpose of this study was to compare urinary tract infection among patients receiving and not receiving a constipation management alert program and catheter removal within five days, and to identify the risk factors for urinary tract infections associated with catheterization in critical neurosurgical patients. The sample was patients with catheter and constipation hospitalized in the Neurosurgical Critical Care Unit of Chiang Mai University Hospital. 228 patients received the constipation management alert program and catheter removal within five days, while 292 patients did not receive the program. Descriptive statistics and logistic regression were used for data analysis.
Results showed that the urinary tract infection rate in patients receiving the constipation management alert program and catheter removal within five days was significantly less than for patients not receiving the program (2.2% and 7.2% respectively, p < .05). The significant risk factors associated urinary tract infection were the length of catheter retention (>5 days, p <.01) and length of stay at the hospital (> 1 week, p < .05). Therefore, nurses should apply this program in clinical practice. Health care teams should communicate comprehensively before using it.
References
American Gastroenterological Association Medical
Position Statement on Constipation. (2018).
Constipation. Retrieved from http://www.
gastro.org/guidelines/constipation-#sec1
Azevedo, R. P. D., & Machado, F. R. (2013).
Constipation in critically ill patients: Much
more than we imagine. Rev Bras Ter
Intensiva. 25(2): 73-74. doi:10.5935/0103-
507X.20130014. Retrieved from https://
www.ncbi.nlm.nih.gov/pmc/articles/PMC
4031826/
Bernard, R. (2000). Fundamentals of biostatistics
(5th ed.). Duxbery: Thomson learning.
Centers for Diseases Control and Prevention.
(2018). Device-associated module: UTI.
Retrieved from: https://www.cdc.gov/nhsn/
pdfs/pscmanual/7psccauticurrent.pdf.
Chen, Y.-Y., Chi, M.-M., Chen, Y.-C., Chan, Y.-J.,
Chou, S.-S., & Wang, F.-D. (2013). Using a
criteria-based reminder to reduce use of
indwelling urinary catheters and decrease
urinary tract infections. American Journal
of Critical Care, 22(2), 105-114. doi:10.4037/
ajcc2013464
Fakih, M. G., Watson, S. R., Greene, M. T., Kennedy,
E. H., Olmsted, R. N., Krein, S. L., & Saint, S.
(2012). Reducing inappropriate urinary
catheter use: A statewide effort. Archives
of Internal Medicine, 172(3), 255-260. doi:
10.1001/archinternmed.2011.627.
Fennessy, G. J., & Warrillow, S. J. (2012).
Gastrointestinal problems in intensive care.
Aneasthesia and Intensive Care Medicine,
13(4), 152-157. Retrieved from https://doi.
org/10.1016/j.mpaic. 2012.01.004
Fleiss, J. L., Levin, B., & Paik, M. C., (2003).
Statistical methods for rates and
proportions (3rd ed.). New Jersey: John
Wiley & Sons.
Horan, T. C., Andrus, M., & Dudeck, M. A. (2008).
CDC/NHSN surveillance definition of health
care-associated infection and criteria for
specific types of infections in the acute care
setting. American Journal of Infection
Control, 36(5), 309-332. doi:10.1016/j.ajic.
2008.03.002
Indrawattana, N., & Vanaporn, M. (2015).
Nosocomial infection. Journal of Medicine
and Health Science, 22(1), 81-92.
Infectious and control Maharaj Nakorn Chiang Mai
Hospital committee. (2013). Hospital
standard policy and 5 days off for CAUTI
prevention. Retrieved from http://www.
med.cmu.ac.th/ hospital/ha /HA/Plates/
5day%20off.pdf. [in Thai].
Infectious and control Maharaj Nakorn Chiang Mai
Hospital committee. (2016). Practice
guideline for hospital infection prevention
and control in Maharaj Nakorn Chiangmai
Hospital. Chiang Mai: Faculty of Medicine
Chiang Mai University. [in Thai]
Jaiyen, P., Punsin, O., Rungrat, S., Seangwan, S.,
Triamvisit, S., & Vaniyapong, T. (2017). PCT
neurosurgery pilot project: Risk factors of
catheter-associated urinary tract infection
in neurosurgical critical care patients. Chiang
Mai: Chiang Mai Regional Forum [in Thai].
Jaiyen, P., Punsin, O., Rungrat, S., Seangwan, S.,
Triamvisit, S., & Vaniyapong, T. (2018). PCT
neurosurgery quality improvement project:
Constipation management alert combined
with catheter removal within five days to
reduce catheter associated urinary tract
infection in neurosurgical critical care
patients. Chiang Mai: Chiang Mai Regional
Forum [in Thai].
Kim, B., Pai, H., Choi, W. S., Kim, Y., Kweon, K. T.,
Kim, H. A., … Kim, J. (2017). Current status
of indwelling urinary catheter utilization
and catheter-associated urinary tract
infection throughout hospital wards in
Korea: A multicenter prospective
observational study. PLOS ONE, 12(10), 1-11.
doi: 10.1371/journal.pone.0185369
Maharaj Nakorn Chiang Mai Hospital. (2021).
Medical records and statistics, Maharaj
Nakorn Chiang Mai Hospital. (2014-2020).
Chiang Mai: Faculty of Medicine Chiang Mai
University. [in Thai]
Masri, Y., Abubaker, J., & Ahmed, R. (2010).
Prophylactic use of laxative for constipation
in critically ill patients. Ann Thorac Med,
5(4), 228-231. doi:10.4103/1817-1737.69113
Meddings, J., Rogers, M. A. M., Macy, M., &
Saint, S. (2010). Systematic review and
meta-analysis: Reminder systems to reduce
catheter-associated urinary tract infections
and urinary catheter use in hospitalized
patients. Clinical Infectious Diseases, 51(5),
550-560. doi:10.1086/655133
Meddings, J., Rogers, M. A. M., Krein, S. L., Fakih,
M. G., Olmsted, R. N., & Saint, S. (2013).
Reducing unnecessary urinary catheter use
and other strategies to prevent catheterassociated
urinary tract infection: An
integrative review. BMJ Quality & Safety,
23(4), 277-289. doi:10.1136/bmjqs-2012-
001774
Meddings, J., Saint, S., Krein, S. L., Gaies, E., Reichert,
H., Hickner, A., … Mody, L. (2017).
Systematic review of interventions to
reduce urinary tract infection in nursing
home residents. Journal of Hospital
Medicine, 12(5), 356-368. doi:10.12788/
jhm.2724
Mostafa, S. M., Bhandari, S, Ritchie, G., Gratton, N.,
& Wenstone, R. (2003). Constipation and its
implications in the critically ill patient. Br J
Anaesth, 91(6), 815-9.
Nassar, A. P.Jr, da Silva, F. M., & de Cleva, R.
(2009). Constipation in intensive care unit:
Incidence and risk factors. J Crit Care, 24(4),
9-12. doi:10.1016/j.jcrc.2009.03.007
Ngamjarus, C., & Chongsuvivatwong, V. (2016).
n4Studies: Sample size calculation for an
epidemiological study on a smart device.
Siriraj Med J, 68(3), 160-170.
Nicolle, L. E. (2014). Catheter associated urinary
tract infections. Antimicrobial Resistance
and Infection Control, 3(1), 23. doi:10.
1186/2047-2994-3-23
Perrin, K., Vats, A., Qureshi, A., Hester, J., Larson,
A., Felipe, A., … Busl, K. (2020). Catheterassociated
urinary tract infection (CAUTI)
in the neuro ICU: Identification of risk factors
and time-to-CAUTI using a case-control
design. Neurocritical Care, 34(1),271-278
doi:10.1007/s12028-020-01020-3
Talaat, M., Hafez, S., Saied, T., Elfeky, R.,
El-Shoubary, W., & Pimentel, G. (2010).
Surveillance of catheter-associated urinary
tract infection in 4 intensive care units at
Alexandria university hospitals in Egypt.
American Journal of Infection Control,
38(3), 222-228. doi:10.1016/j.ajic.2009.06.011
Temiz, E., Piskin, N., Aydemir, H., Oztoprak, N.,
Akduman, D., Celebi, G., & Kokturk, F. (2011).
Factors associated with catheter-associated
urinary tract infections and the effects of
other concomitant nosocomial infections
in intensive care units. Scandinavian
Journal of Infectious Diseases, 44(5),
344-349. doi:10.3109/00365548.2011.639031
Tsuchida, T., Makimoto, K., Ohsako, S., Fujino, M.,
Kaneda, M., Miyazaki, T., … Sugimoto, T.
(2008). Relationship between catheter care
and catheter-associated urinary tract
infection at Japanese general hospitals:
A prospective observational study.
International Journal of Nursing Studies,
45(3), 352-361. doi:10.1016/j.ijnurstu.2006.
10.006
Unahalekhaka, A. (2012). Prevention of
nosocomial infections principles and
guidelines (2nd ed.). Chiang Mai: Ming
Muang Navarat.
Position Statement on Constipation. (2018).
Constipation. Retrieved from http://www.
gastro.org/guidelines/constipation-#sec1
Azevedo, R. P. D., & Machado, F. R. (2013).
Constipation in critically ill patients: Much
more than we imagine. Rev Bras Ter
Intensiva. 25(2): 73-74. doi:10.5935/0103-
507X.20130014. Retrieved from https://
www.ncbi.nlm.nih.gov/pmc/articles/PMC
4031826/
Bernard, R. (2000). Fundamentals of biostatistics
(5th ed.). Duxbery: Thomson learning.
Centers for Diseases Control and Prevention.
(2018). Device-associated module: UTI.
Retrieved from: https://www.cdc.gov/nhsn/
pdfs/pscmanual/7psccauticurrent.pdf.
Chen, Y.-Y., Chi, M.-M., Chen, Y.-C., Chan, Y.-J.,
Chou, S.-S., & Wang, F.-D. (2013). Using a
criteria-based reminder to reduce use of
indwelling urinary catheters and decrease
urinary tract infections. American Journal
of Critical Care, 22(2), 105-114. doi:10.4037/
ajcc2013464
Fakih, M. G., Watson, S. R., Greene, M. T., Kennedy,
E. H., Olmsted, R. N., Krein, S. L., & Saint, S.
(2012). Reducing inappropriate urinary
catheter use: A statewide effort. Archives
of Internal Medicine, 172(3), 255-260. doi:
10.1001/archinternmed.2011.627.
Fennessy, G. J., & Warrillow, S. J. (2012).
Gastrointestinal problems in intensive care.
Aneasthesia and Intensive Care Medicine,
13(4), 152-157. Retrieved from https://doi.
org/10.1016/j.mpaic. 2012.01.004
Fleiss, J. L., Levin, B., & Paik, M. C., (2003).
Statistical methods for rates and
proportions (3rd ed.). New Jersey: John
Wiley & Sons.
Horan, T. C., Andrus, M., & Dudeck, M. A. (2008).
CDC/NHSN surveillance definition of health
care-associated infection and criteria for
specific types of infections in the acute care
setting. American Journal of Infection
Control, 36(5), 309-332. doi:10.1016/j.ajic.
2008.03.002
Indrawattana, N., & Vanaporn, M. (2015).
Nosocomial infection. Journal of Medicine
and Health Science, 22(1), 81-92.
Infectious and control Maharaj Nakorn Chiang Mai
Hospital committee. (2013). Hospital
standard policy and 5 days off for CAUTI
prevention. Retrieved from http://www.
med.cmu.ac.th/ hospital/ha /HA/Plates/
5day%20off.pdf. [in Thai].
Infectious and control Maharaj Nakorn Chiang Mai
Hospital committee. (2016). Practice
guideline for hospital infection prevention
and control in Maharaj Nakorn Chiangmai
Hospital. Chiang Mai: Faculty of Medicine
Chiang Mai University. [in Thai]
Jaiyen, P., Punsin, O., Rungrat, S., Seangwan, S.,
Triamvisit, S., & Vaniyapong, T. (2017). PCT
neurosurgery pilot project: Risk factors of
catheter-associated urinary tract infection
in neurosurgical critical care patients. Chiang
Mai: Chiang Mai Regional Forum [in Thai].
Jaiyen, P., Punsin, O., Rungrat, S., Seangwan, S.,
Triamvisit, S., & Vaniyapong, T. (2018). PCT
neurosurgery quality improvement project:
Constipation management alert combined
with catheter removal within five days to
reduce catheter associated urinary tract
infection in neurosurgical critical care
patients. Chiang Mai: Chiang Mai Regional
Forum [in Thai].
Kim, B., Pai, H., Choi, W. S., Kim, Y., Kweon, K. T.,
Kim, H. A., … Kim, J. (2017). Current status
of indwelling urinary catheter utilization
and catheter-associated urinary tract
infection throughout hospital wards in
Korea: A multicenter prospective
observational study. PLOS ONE, 12(10), 1-11.
doi: 10.1371/journal.pone.0185369
Maharaj Nakorn Chiang Mai Hospital. (2021).
Medical records and statistics, Maharaj
Nakorn Chiang Mai Hospital. (2014-2020).
Chiang Mai: Faculty of Medicine Chiang Mai
University. [in Thai]
Masri, Y., Abubaker, J., & Ahmed, R. (2010).
Prophylactic use of laxative for constipation
in critically ill patients. Ann Thorac Med,
5(4), 228-231. doi:10.4103/1817-1737.69113
Meddings, J., Rogers, M. A. M., Macy, M., &
Saint, S. (2010). Systematic review and
meta-analysis: Reminder systems to reduce
catheter-associated urinary tract infections
and urinary catheter use in hospitalized
patients. Clinical Infectious Diseases, 51(5),
550-560. doi:10.1086/655133
Meddings, J., Rogers, M. A. M., Krein, S. L., Fakih,
M. G., Olmsted, R. N., & Saint, S. (2013).
Reducing unnecessary urinary catheter use
and other strategies to prevent catheterassociated
urinary tract infection: An
integrative review. BMJ Quality & Safety,
23(4), 277-289. doi:10.1136/bmjqs-2012-
001774
Meddings, J., Saint, S., Krein, S. L., Gaies, E., Reichert,
H., Hickner, A., … Mody, L. (2017).
Systematic review of interventions to
reduce urinary tract infection in nursing
home residents. Journal of Hospital
Medicine, 12(5), 356-368. doi:10.12788/
jhm.2724
Mostafa, S. M., Bhandari, S, Ritchie, G., Gratton, N.,
& Wenstone, R. (2003). Constipation and its
implications in the critically ill patient. Br J
Anaesth, 91(6), 815-9.
Nassar, A. P.Jr, da Silva, F. M., & de Cleva, R.
(2009). Constipation in intensive care unit:
Incidence and risk factors. J Crit Care, 24(4),
9-12. doi:10.1016/j.jcrc.2009.03.007
Ngamjarus, C., & Chongsuvivatwong, V. (2016).
n4Studies: Sample size calculation for an
epidemiological study on a smart device.
Siriraj Med J, 68(3), 160-170.
Nicolle, L. E. (2014). Catheter associated urinary
tract infections. Antimicrobial Resistance
and Infection Control, 3(1), 23. doi:10.
1186/2047-2994-3-23
Perrin, K., Vats, A., Qureshi, A., Hester, J., Larson,
A., Felipe, A., … Busl, K. (2020). Catheterassociated
urinary tract infection (CAUTI)
in the neuro ICU: Identification of risk factors
and time-to-CAUTI using a case-control
design. Neurocritical Care, 34(1),271-278
doi:10.1007/s12028-020-01020-3
Talaat, M., Hafez, S., Saied, T., Elfeky, R.,
El-Shoubary, W., & Pimentel, G. (2010).
Surveillance of catheter-associated urinary
tract infection in 4 intensive care units at
Alexandria university hospitals in Egypt.
American Journal of Infection Control,
38(3), 222-228. doi:10.1016/j.ajic.2009.06.011
Temiz, E., Piskin, N., Aydemir, H., Oztoprak, N.,
Akduman, D., Celebi, G., & Kokturk, F. (2011).
Factors associated with catheter-associated
urinary tract infections and the effects of
other concomitant nosocomial infections
in intensive care units. Scandinavian
Journal of Infectious Diseases, 44(5),
344-349. doi:10.3109/00365548.2011.639031
Tsuchida, T., Makimoto, K., Ohsako, S., Fujino, M.,
Kaneda, M., Miyazaki, T., … Sugimoto, T.
(2008). Relationship between catheter care
and catheter-associated urinary tract
infection at Japanese general hospitals:
A prospective observational study.
International Journal of Nursing Studies,
45(3), 352-361. doi:10.1016/j.ijnurstu.2006.
10.006
Unahalekhaka, A. (2012). Prevention of
nosocomial infections principles and
guidelines (2nd ed.). Chiang Mai: Ming
Muang Navarat.
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Published
2021-09-28
How to Cite
Triamvisit, S., Jaiyen, P., Punsin, O., Rungrat, S., Seangwan, S., & Vaniyapong, T. (2021). Effects of Constipation Management Alert Combined with Catheter Removal on Urinary Tract Infection Among Critical Neurosurgical Patients. The Journal of Faculty of Nursing Burapha University, 29(3), 90–101. retrieved from https://he02.tci-thaijo.org/index.php/Nubuu/article/view/253996
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