The study by Zavodnick et al. (2020) investigates the effect of female external urinary catheters (FEUCs) on indwelling urinary catheter (IUC) use and catheter-associated urinary tract infections (CAUTIs) in females. The authors indicate that while IUCs are commonly utilized in hospitals, they are risk factors for CAUTIs, which are associated with increased lengthy hospitalization stays, mortality, and costs. Zavodnick et al. (2020) used a retrospective observational study design, where participants comprised ICU patients. A hypothesis that FEUC can minimize the use of IUC, preventing CAUTIs, guided the study.
All adults who were in the ICU in the targeted hospital from January 1, 2017, to December 31, 2019, participated in the study, resulting in a sample of 89,856 patient days. The authors collected data regarding rates of CAUTI in female ICU patients in the first year of the study and compared it with that recorded in the subsequent two years, after which the FEUC was introduced. They also excluded male patients when calculating IUC days, CAUTI rates, and hospital-acquired pressure injury (HAPI) rates.
The intervention in the study involved the introduction of PureWick FEUC to all patients in the ICU in January 2018. The device has a urine collection segment that healthcare providers can position between patients’ labia. Nurses used appropriate indication guidelines to decide on FEUC use in a particular patient. Fundamental indications included strict monitoring of intake and output without using alternative means and moisture dermatitis. The CAUTI working group oversaw the introduction of FEUC, and several nurses in each unit were trained on how to use the device.
The results indicate that 23 female ICU patients had CAUTIs at the rate of 3.14 per 1000 indwelling catheter days before the introduction of FEUC. The number was reduced to 17 CAUTIs, a rate of 1.42 per 1000 indwelling catheters following the introduction of FEUC, where the p-value was 0.013 (Zavodnick et al., 2020). The ICU indwelling catheter days decreased by 18.2% (from 610 to 499), while average monthly ICU patient days increased from 2392 to 2548 (Zavodnick et al., 2020). The findings support the hypothesis that FEUC can minimize the use of IUC, preventing CAUTIs.
Reference
Zavodnick, J., Harley, C., Zabriskie, K., & Brahmbhatt, Y. (2020). Effect of a female external urinary catheter on incidence of catheter-associated urinary tract infection. Cureus, 12(10), 1-7. Web.