Domin MA. Highly virulent pathogens--a post antibiotic era? Br J Theatr Nurs. 1998;8(2):14–8.
CAS Google Scholar
Fishman N. Antimicrobial stewardship. Am J Med. 2006;119(6 Suppl 1):S53–61 discussion S62-70.
Article Google Scholar
Loveday HP, Wilson JA, Pratt RJ, Golsorkhi M, Tingle A, Bak A, et al. epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. J Hosp Infect. 2014;86(Suppl 1):S1–70.
Article Google Scholar
Adams D, Bucior H, Day G, Rimmer J-A, et al. J Infect Prev. 2012;13(2):44–6.
Article Google Scholar
Codd J. Implementation of a patient-held urinary catheter passport to improve catheter management, by prompting for early removal and enhancing patient compliance. J Infect Prev. 2014;15(3):88–92.
Article Google Scholar
Michie S, Johnston M, Francis J, Hardeman W, Eccles MP, et al. Appl Psychol. 2008;57(4):660–80.
Article Google Scholar
Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci. 2011;6:42.
Article Google Scholar
Michie S, Richardson M, Johnston M, Abraham C, Francis J, Hardeman W, et al. Ann Behav Med. 2013;46(1):81–95.
Article Google Scholar
Michie S, Atkins L, West R. The behaviour change wheel - a guide to designing interventions. Great Britain: Silverback Publishing; 2014.
Google Scholar
Steinmo SH, Michie S, Fuller C, Stanley S, Stapleton C, Stone SP. Bridging the gap between pragmatic intervention design and theory: using behavioural science tools to modify an existing quality improvement programme to implement “sepsis six”, Implementation science. 2016;11(1):14.
Lawrenson JG, Graham-Rowe E, Lorencatto F, Burr J, Bunce C, Francis JJ, et al. Interventions to increase attendance for diabetic retinopathy screening. Cochrane Database Syst Rev. 2018;1:Cd012054.
PubMed Google Scholar
Graham-Rowe E, Lorencatto F, Lawrenson JG, Burr JM, Grimshaw JM, Ivers NM, et al. Barriers to and enablers of diabetic retinopathy screening attendance: a systematic review of published and grey literature. Diabet Med. 2018;35(10):1308–19.
CAS Article Google Scholar
Lawrenson JG, Graham-Rowe E, Lorencatto F, Rice S, Bunce C, Francis JJ, et al. What works to increase attendance for diabetic retinopathy screening? An evidence synthesis and economic analysis. Health Technol Assess. 2018;22(29):1–160.
Article Google Scholar
Pluye, P. Robert, E. Cargo, M. Bartlett, G. O’Cathain, A. Griffiths, F. Boardman, F. Gagnon, MP. Rousseau, MC. Proposal: a mixed methods appraisal tool for systematic mixed studies reviews. 2011. Available from: //mixedmethodsappraisaltoolpublic.pbworks.com/FrontPage. Cited 2018.
Srivastava, A. and S. Thompson, Framework analysis: a qualitative methodology for applied policy research. Journal of Administration and Governance. 2009;4:(2).
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.
Article Google Scholar
Atkins L, Francis J, Islam R, O'Connor D, Patey A, Ivers N, et al. A guide to using the theoretical domains framework of behaviour change to investigate implementation problems. Implement Sci. 2017;12(1):77.
Article Google Scholar
Michie S, Johnston M, Francis J, Hardeman W, Eccles M. From theory to intervention: mapping theoretically derived behavioural determinants to behaviour change techniques. Appl Psychol. 2008;57(4):660–80.
Article Google Scholar
Cane J, Richardson M, Johnston M, Ladha R, Michie S. From lists of behaviour change techniques (BCTs) to structured hierarchies: comparison of two methods of developing a hierarchy of BCTs. Br J Health Psychol. 2015;20(1):130–50.
Article Google Scholar
Getliffe K, Newton T. Catheter-associated urinary tract infection in primary and community health care. Age & Ageing. 2006;35(5):477–81.
Article Google Scholar
Krein SL, Harrod M, Collier S, Davis KK, Rolle AJ, Fowler KE, et al. A national collaborative approach to reduce catheter-associated urinary tract infections in nursing homes: a qualitative assessment. American Journal of Infection Control. 2017;45(12):1342–8.
Article Google Scholar
Krein SL, Kowalski CP, Harrod M, Forman J, Saint S. Barriers to reducing urinary catheter use: a qualitative assessment of a statewide initiative. JAMA Intern Med. 2013;(10):173, 881–6.
Harrod M, Kowalski CP, Saint S, Forman J, Krein SL. Variations in risk perceptions: a qualitative study of why unnecessary urinary catheter use continues to be problematic. BMC Health Serv Res. 2013;13:151.
Article Google Scholar
Alexaitis I, Broome B. Implementation of a nurse-driven protocol to prevent catheter-associated urinary tract infections. J Nurs Care Qual. 2014;29(3):245–52.
Article Google Scholar
Andreessen L, Wilde MH, Herendeen P. Preventing catheter-associated urinary tract infections in acute care: the bundle approach. J Nurs Care Qual. 2012;27(3):209–17.
Article Google Scholar
Apisarnthanarak A, Ratz D, Greene MT, Khawcharoenporn T, Weber DJ, Saint S. National survey of practices to prevent health care-associated infections in Thailand: the role of prevention bundles. Am J Infect Control. 2017;45(7):805–10.
Article Google Scholar
Bursle EC, Dyer J, Looke DF, McDougall DA, Paterson DL, Playford EG. Risk factors for urinary catheter associated bloodstream infection. J Infect. 2015;70(6):585–91.
Article Google Scholar
Carter EJ, Pallin DJ, Mandel L, Sinnette C, Schuur JD. Emergency department catheter-associated urinary tract infection prevention: multisite qualitative study of perceived risks and implemented strategies. Infect Control Hospl Epidemiol. 2016;37(2):156–62.
Article Google Scholar
Carter EJ, Pallin DJ, Mandel L, Sinnette C, Schuur JD. A qualitative study of factors facilitating clinical nurse engagement in emergency department catheter-associated urinary tract infection prevention. J Nurs Adm. 2016;46(10):495–500.
Article Google Scholar
Hu FW, Yang DC, Huang CC, Chen CH, Chang CM. Inappropriate use of urinary catheters among hospitalized elderly patients: clinician awareness is key. Geriatr Gerontol Int. 2015;15(12):1235–41.
Article Google Scholar
Conner BT, Kelechi TJ, Nemeth LS, Mueller M, Edlund BJ, Krein SL. Exploring factors associated with nurses’ adoption of an evidence-based practice to reduce duration of catheterization. J Nurs Care Qual. 2013;28(4):319–26.
Article Google Scholar
Conway LJ, Pogorzelska M, Larson E, Stone PW. Adoption of policies to prevent catheter-associated urinary tract infections in United States intensive care units. Am J Infect Control. 2012;40(8):705–10.
Article Google Scholar
Crouzet J, Bertrand X, Venier AG, Badoz M, Husson C, Talon D. Control of the duration of urinary catheterization: impact on catheter-associated urinary tract infection. J Hosp Infect. 2007;67(3):253–7.
CAS Article Google Scholar
Dugyon-Escalante J, Yoon J, Lavelle J, Naungayan A. The impact of multidisciplinary team approach to combat catheter associated urinary tract infection in a large government hospital. Am J Infect Control. 2015;43(6 Supplement 1):S45–6.
Article Google Scholar
Fakih MG, Dueweke C, Meisner S, Berriel-Cass D, Savoy-Moore R, Brach N, et al. Effect of nurse-led multidisciplinary rounds on reducing the unnecessary use of urinary catheterization in hospitalized patients. Infect Control Hosp Epidemiol. 2008;29(9):815–9.
Article Google Scholar
Fakih MG, George C, Edson BS, Goeschel CA, Saint S. Implementing a national program to reduce catheter-associated urinary tract infection: a quality improvement collaboration of state hospital associations, academic medical centers, professional societies, and governmental agencies. Infect Control Hosp Epidemiol. 2013;34(10):1048–54.
Article Google Scholar
Gupta SS, Irukulla PK, Shenoy MA, Nyemba V, Yacoub D, Kupfer Y. Successful strategy to decrease indwelling catheter utilization rates in an academic medical intensive care unit, Am J Infect Control. 2017;45(12):1349–55.
Mann P, Vandygriff C, Kingsberry L, Horne R, Strelczyk K. Catheter-associated urinary tract infection (CAUTI): a significant case for concern. Am J Infect Control. 2013;1:–S124.
Murphy C, Prieto J, Fader M. “It’s easier to stick a tube in”: a qualitative study to understand clinicians’ individual decisions to place urinary catheters in acute medical care. BMJ Quality & Safety. 2015;24(7):444–50.
Article Google Scholar
Patrizzi K, Fasnacht A, Manno M. A collaborative, nurse-driven initiative to reduce hospital-acquired urinary tract infections. J Emerg Nurs. 2009;35(6):536–9.
Article Google Scholar
Smith LC, Peyton J, Krout K, Cox CA, Huber KL. Decreasing the rate of catheter-associated urinary tract infections through a nurse-driven intervention. J Burn Care Res. 2015;36:S147.
Google Scholar
Fakih MG, Pena ME, Shemes S, Rey J, Berriel-Cass D, Szpunar SM, et al. Effect of establishing guidelines on appropriate urinary catheter placement. Acad Emerg Med. 2010;17(3):337–40.
Article Google Scholar
Trautner BW, Petersen NJ, Hysong SJ, Horwitz D, Kelly PA, Naik AD, et al. Am J Infect Control. 2014;42(6):653–8.
Article Google Scholar
Kolonoski P, Stanley K, Anderson K. An interdisciplinary approach toward reducing the incidence of catheter-associated urinary tract infections in a post-acute facility. Am J Infect Control. 2012;40(5):e54–5.
Article Google Scholar
Grol R, Grimshaw J. From best evidence to best practice: effective implementation of change in patients’ care. Lancet. 2003;362(9391):1225–30.
Article Google Scholar
Page 2
Skip to main content
From: Reducing catheter-associated urinary tract infections: a systematic review of barriers and facilitators and strategic behavioural analysis of interventions
Community care | |||||
Getliffe & Newton [20] | UK | Not specified | District nurses (101/129 total sample; 18 community hospital and 10 nursing home care staff) | Record keeping relating to catheter care and CAUTI | Self-report questionnaire |
Nursing home | |||||
Krein et al. [21]. | USA | Not specified | Organizational and facility leaders | Implementing ‘The Agency for Healthcare Research and Quality (AHRQ) Safety Program for Long-term Care: Health Care-Associated Infections/Catheter-Associated Urinary Tract Infection' | Semi-structured telephone interviews |
Secondary care | |||||
Krein et al. [22] Harrod et al. [23] | USA | Not specified | Infection control nurse (42), nurse/nurse manager (25), other, e.g. quality manager (2), hospital epidemiologist or infectious diseases physician (1); prevention specialists | Implementing the ‘Bladder Bundle’ care package | Semi-structured interview |
Alexaitis & Broome [24] | USA | Neuroscience intensive care unit: common diagnoses include aneurysms, arteriovenous malformations, central nervous system neoplasms, traumatic brain injuries, spinal cord injuries, hemorrhagic and ischemic strokes, and status epilepticus. | Patients (183), nurses (107) | Discontinuation of indwelling catheters and use of bladder ultrasonography in conjunction with intermittent catheterizations | Pre-post study: catheter utilization, CAUTI rates, number of CAUTIs per month, LOS (length of stay, and cost associated with treating CAUTIs |
Andreessen et al. [25] | USA | Not specified | Male in-patients with acute indwelling urinary catheters; staff of the medical centre | Implementing evidence-based guidelines and a urinary catheter bundle (Adult Catheter Bundle) focusing on optimizing the use of urinary catheters through continual assessment and prompt catheter removal. | Pre-post study: catheter device days, compliance with urinary catheter orders, and computer documentation of continued catheter indications. |
Apisarnthanarak et al. [26] | Thailand | Not specified | Survey: general personnel; interview: lead infection preventionist | Prevention practices for CAUTI, CLABSI and VAP | Survey; interview assessing prevention practices |
Bursle et al. [27] | Australia | Not specified | Patients with urinary source bloodstream infection associated with an indwelling urinary catheter | Insertion of urinary catheter. | Case-control study: assessing risk factors for urinary catheter associated bloodstream infection |
Carter et al. [28] Carter et al. [29] | USA | Not specified | Staff at emergency department | Implementing a CAUTI prevention program among Emergency Departments | Qualitative comparative case study |
Hu et al. [30] | Taiwan | Not specified | 65 years or older | Insertion of urinary catheter | Prospective study: risk factors and outcomes for inappropriate use of urinary catheters |
Conner et al. [31] | USA | Not specified | Nurses | Nurse driven early catheter discontinuation; assessing a patient’s need for indwelling urinary catheterization beyond 48 h | Pre-post study: factors associated with nurses’ adoption of an evidence-based practice to reduce the duration of catheterization |
Conway et al. [32] | USA | Not specified | IPC (infection prevention control) department managers or directors | Adherence to CAUTI prevention policies | Cross-sectional survey on presence of CAUTI prevention policies, adherence to policies, CAUTI incidence rates |
Crouzet et al. [33] | France | Not specified | Five hospital departments (not specified further) | Reducing the duration of the catheterisation | Non-random intervention study: duration of catheterisation, late CAUTI frequency |
Dugyon-Escalante et al. [34] | USA | Not specified | Patients in intensive care units | Managing catheter use by multidisciplinary teams | Number of CAUTI cases and infection rates: pre-post |
Fakih et al. [35] | USA | Not specified | Patients in medical-surgical units | Unnecessary use of urinary catheters | Quasi-experimental study with a control group: reduction in the rate of UC utilization |
Fakih et al. [36] | USA | Not specified | Nurse and physician champions. Nurses caring for the patients. Other healthcare workers (e.g. infection preventionist, quality manager, safety officer, utilization manager) | Urinary catheter use and appropriateness of the indication for use (accountability at the unit level). | Symptomatic National Healthcare Safety Network (NHSN) CAUTI rate and population-based CAUTI rate. AHRQ's Hospital Survey on Patient Safety Culture administered both at baseline and 15 months later to evaluate changes in patient safety culture over time. Readiness assessment per unit at the beginning of the project and team check-up tool quarterly to report on progress with the implementation of CUSP principles and barriers |
Gupta et al. [37] | USA | Not specified (ICU patients) | MICU medical director, MICU fellows, nurse managers and an infection control nurse | 1. Restricting IUC use to a limited list of predetermined indications. 2. Physicians and nurses were required to discontinue urinary catheters in all patients on admission unless warranted. 3. Narrowing down the criteria for urinary catheter utilization to urinary retention and genitourinary procedures only. 4. Use of sonographic bladder scanning to identify high-risk patients who may need indwelling catheters in the near future | IUC utilization ratio (number of urinary catheter days/patient days) and catheter-associated urinary tract infection (CAUTI) rates (number of CAUTI infections in a particular location or number of urinary catheter days in a particular location × 1000) |
Mann et al. [38] | Canada | Not specified (intensive care units and rehabilitation unit) | Intensive care and rehabilitation unit nurses | Compliance with CAUTI prevention measures (Foley maintenance) | Compliance with the following evidence-based practices: catheter securement, tamper evident seal (TES) intact, absence of dependent loop, catheter below bladder level, drainage bag not touching floor and drainage bag not overfilled |
Murphy et al. [39] | UK | Not specified (ED, medical assessment unit, cardiology wards, and older people’s acute medicine wards) | 8 nurses and 22 physicians in retrospective think aloud - RTA interviews. 20 of these (not specified how many nurses/physicians) also took part in a semi-structured interview | Decision making regarding IUC placement | 30 RTA interviews and 20 semi-structured interviews |
Patrizzi et al. [40] | USA | Not specified (ED and inpatient units) | ED nurses | Implementing a nurse-driven protocol to reduce CAUTI: Emergency department behaviours: 1. Removing direct access to catheters by placing them centrally in a supply closet instead of in each bedside supply cart. 2. Only storing 14F catheters (and no larger ones) in the supply closet as risk of infection increases with size. 3. Adding intermittent urinary catheterization kits to the supply closet as an alternative. 4. Education (e.g., The PPMC ‘UTI Bundle’ mandatory education day). 5. Availability of a bladder scanner. 6. New order set for indwelling urinary catheterization that lists 5 different indications to justify catheter placement (following hospital policy) instead of the previous ‘Foley catheter insertion’ order. 7. Collaboratively discussion between physician and nurse if the latter feels the insertion does not meet the established criteria. Inpatient unit behaviours: 1. Monitoring sheet placed on each patient’s medical record. 2. Daily assessment of a. necessity and b. standards for managing the catheter are being kept (e.g. bag below level of bladder) | Percentage of patients admitted from ER with indwelling urinary catheters |
Smith L et al. [41] | USA | Not specified | Burn ICU nurses | Insertion, maintenance and removal of urinary catheters. | CAUTI rates and catheter utilization rates |
Tertiary care | |||||
Fakih et al. [42] | USA | Not specified | EPs and resident staff in ED | Adherence to guidelines for urinary catheter placement | Data on urinary catheter presence on emergency department arrival, placement of a urinary catheter in the emergency department, documentation of a physician order for urinary catheter placement, reasons for placement, and compliance with the indications were collected retrospectively reviewing the emergency department records |
Trautner et al. [43] | USA | Not specified | 169 physicians | Management of catheter-associated urine cultures | Self-report questionnaire |
Kolonoski et al. [44] | USA | Not specified (post-acute units patients) | Physicians and nurses | Implementation of quality improvement programme to reduce CAUTI | Interview and point prevalence survey of Foley catheter use |