Prevention of catheter-associated urinary tract infection: What is the gap in clinical practice?

Abstract

Objective: to identify the gap in the prevention of catheter-associated urinary tract infection. Method: an observational study conducted by an audit of process indicators in relation to the recommendations for preventing catheter-associated urinary tract infection during its maintenance and handling. The collection was carried out between July and September of 2017 in an adult intensive care unit located in the state of Minas Gerais, Brazil. The observations were made with the help of a developed instrument for the present study and the data were analyzed by means of descriptive statistics. Results: 451 evaluations were performed related to maintenance of the urinary catheter with a focus on its fixation, the collector bag maintenance, and volume and urinary flow of the drainage system. Regarding clinical practice gaps, inadequate fixation of the urinary catheter and drainage pocket were found, with more than three-quarters of its capacity filled (97.7% and 3.5%, respectively). Regarding the handling of 556 urinary catheters, there was non-conformity in the hygiene of the urethral meatus in 22.9% of the situations, and nonadherence to hands hygiene before and after handling the urinary catheter was 94.2% and 66.5%, respectively (p=0.002). Conclusion: isolated measures had good adherence rates, but prevention of catheter-associated urinary tract infection should be based on adherence to several measures simultaneously. The prevention gap is in the awareness of health professionals that the recognized prevention measures of catheter - associated urinary tract infection should be adopted collectively in order to guarantee patient and clinical practice safety.