North Texas GME Research Forum 2024

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Division

North Texas

Hospital

Medical City Weatherford

Specialty

Internal Medicine

Document Type

Poster

Publication Date

2024

Keywords

CAUTI, catheter-associated uirinary tract infections, quality improvement, tamsulosin

Disciplines

Bacterial Infections and Mycoses | Internal Medicine | Medicine and Health Sciences | Quality Improvement

Abstract

Among Catheter-Associated Urinary Tract Infections (CAUTI) acquired in the hospital, approximately 75% are associated with a urinary catheter, which is a tube inserted into the bladder through the urethra to drain urine. Between 15-25% of hospitalized patients receive urinary catheters during their hospital stay. A urinary tract infection (UTI) is an infection involving any part of the urinary system, including urethra, bladder, ureters, and kidney. UTIs are the most common type of healthcare-associated infection reported to the National Healthcare Safety Network (NHSN). The most important risk factor for developing a CAUTI is prolonged use of the urinary catheter. Therefore, catheters should only be used for appropriate indications and should be removed as soon as they are no longer needed. Tamsulosin is a selective alpha1A-adrenergic receptor antagonist. The effects of tamsulosin are targeted for the smooth muscle receptors of the prostate and urethra. Blocking this receptor relaxes the smooth muscle of the bladder and urethra to improve urine flow. There is limited evidence available examining the impact of tamsulosin and duration of foley catheter particularly in urinary obstruction, hence reducing the risk for CAUTI. The present meta-analysis indicated that prophylactic tamsulosin helps in preventing POUR (post-operative urinary retention) and younger patients might benefit more from this preventive regimen. Our goal is to utilize retrospective data for last 2-3 months and include the patient with CAUTI who were on foley catheter due to urinary retention. We excluded patients with urinary retention due to other cause and post-operative patient on foley catheter. then determine when Tamsulosin was administered and whether it impact de-escalation of foley catheter. As the number of CAUTI increases with duration of foley catheter kept>2 calendar days. During month of November and December 2023, total 163 hospitalized patient required indwelling Foley catheter. November 2023: 3 patients requited foley for acute retention , 18 for perioperative ,7 for prolonged immobilization, 30 patients required for measurement of accurate and input and output and 7 for chronic retention. December 2023: 6 patients required Foley for acute urinary retention, 31 for perioperative, 7 for prolong mobilization, 34 for measurement of accurate input and output, 10 for chronic retention, 2 for palliative care, 44 assist in wound healing, 2 for ICU/ critically ill patients. No hospital acquired CAUTI during this period. Education and daily evaluation of indwelling urinary catheter indications were highly effective in reducing the rates of catheter utilization as well as the incidence density of CAUTI.

Original Publisher

HCA Healthcare Graduate Medical Education

The Impact of Tamsulosin and Duration in Catheter-associated UTI (CAUTI) at Weatherford

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