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The role and importance of urologists in the activities for the management and prevention of CAUTI during ICU management; Infection only vs. infection & voiding management |
| 가톨릭대학교 의정부성모병원 비뇨기과학 교실¹, 건국대학교 충주병원 비뇨기과학 교실² |
| 배상락¹, 김은재¹, 최우석¹, 박봉희¹, 정홍², 이용석¹, 한창희¹ |
Objetives : In order to manage and prevent CAUTI, we would like to investigate the effect of intervention as a urologist on infection prevention activities in hospitals.
Material and methods : CAUTI rounding was conducted 41 times from July 2018 to June 2020, we analyzed the changes and improvement activities in ICU infection management in a multidisciplinary approach, led by urologists. 2~3 times a month, a collaborative team of urology specialists, ICU nurses, and infection control experts determines the adequacy and management of Foley catheters in patients, and recommends removal or replacement, or recommendations were given for infection control. Through other improvement activities, we analyzed the changes that occurred in terms of urination management as well as infection control.
Results : Catheter alarm is applied to EMR, stickers attached to precautions for urine management, primary judgment through periodic nurse administration, catheter fixation position by gender, height of urine bag, hand hygiene before procedure, maintenance of closed system, maintenance of sterilization upon insertion, etc. about 8 items were investigated. After applying the alarm, the replacement did not occur for more than 4 weeks (performance rate 100%), caution stickers attached, closed system maintenance, fixed position, urine bag height maintenance, hand hygiene, etc. were performed through regular monitoring. Depending on the item, the rate was confirmed from less than 50% before starting to about 90% or more. However, nursing assessment for indications, aseptic catheterization, etc. were of the highest importance, but due to the disadvantages of difficulty in evaluation, recommendations for catheter removal were given each time during the round. When the recommendation was delivered, the lowest performance rate was the evaluation of the risk of urination difficulties, and after consultation, 100% urination management and outpatient progress were observed.
Conclusion : CAUTI is an important item in certification evaluation, and improvement activities are important. Due to the location of the urologist at the center of the activity, it can be expected to play a major role in the position and role of the urologist as a urologist if not only managing urinary tract infections but also controlling urination after removal. |
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keywords : Catheter-associated UTI, ICU, Rounding |
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