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Change in staff perspectives on indwelling urinary catheter use after implementation of an intervention bundle in seven Swiss acute care hospitals: results of a before/after survey study


Niederhauser, Andrea; Züllig, Stephanie; Marschall, Jonas; Schweiger, Alexander; John, Gregor; Kuster, Stefan P; Schwappach, David Lb (2019). Change in staff perspectives on indwelling urinary catheter use after implementation of an intervention bundle in seven Swiss acute care hospitals: results of a before/after survey study. BMJ Open, 9(10):e028740.

Abstract

OBJECTIVE To evaluate changes in staff perspectives towards indwelling urinary catheter (IUC) use after implementation of a 1-year quality improvement project.
DESIGN Repeated cross-sectional survey at baseline (October 2016) and 12-month follow-up (October 2017).
SETTING Seven acute care hospitals in Switzerland.
PARTICIPANTS The survey was targeted at all nursing and medical staff members working at the participating hospitals at the time of survey distribution. A total of 1579 staff members participated in the baseline survey (T) (49% response rate) and 1527 participated in the follow-up survey (T) (47% response rate).
INTERVENTION A multimodal intervention bundle, consisting of an evidence-based indication list, daily re-evaluation of ongoing catheter need and staff training, was implemented over the course of 9 months.
MAIN OUTCOME MEASURES Staff knowledge (15 items), perception of current practices and culture (scale 1-7), self-reported responsibilities (multiple-response question) and determinants of behaviour (scale 1-7) before and after implementation of the intervention bundle.
RESULTS The mean number of correctly answered knowledge questions increased significantly between the two survey periods (T: 10.4, T: 11.0; p<0.001). Self-reported responsibilities with regard to IUC management by nurses and physicians changed only slightly over time. Perception of current practices and culture in regard to safe urinary catheter use increased significantly (T: 5.3, T: 5.5; p<0.001). Significant changes were also observed for determinants of behaviour (T: 5.3, T: 5.6; p<0.001).
CONCLUSION We found small but significant changes in staff perceptions after implementation of an evidence-based intervention bundle. Efforts now need to be targeted at sustaining and reinforcing these changes, so that restrictive use of IUCs becomes an integral part of the hospital culture.

Abstract

OBJECTIVE To evaluate changes in staff perspectives towards indwelling urinary catheter (IUC) use after implementation of a 1-year quality improvement project.
DESIGN Repeated cross-sectional survey at baseline (October 2016) and 12-month follow-up (October 2017).
SETTING Seven acute care hospitals in Switzerland.
PARTICIPANTS The survey was targeted at all nursing and medical staff members working at the participating hospitals at the time of survey distribution. A total of 1579 staff members participated in the baseline survey (T) (49% response rate) and 1527 participated in the follow-up survey (T) (47% response rate).
INTERVENTION A multimodal intervention bundle, consisting of an evidence-based indication list, daily re-evaluation of ongoing catheter need and staff training, was implemented over the course of 9 months.
MAIN OUTCOME MEASURES Staff knowledge (15 items), perception of current practices and culture (scale 1-7), self-reported responsibilities (multiple-response question) and determinants of behaviour (scale 1-7) before and after implementation of the intervention bundle.
RESULTS The mean number of correctly answered knowledge questions increased significantly between the two survey periods (T: 10.4, T: 11.0; p<0.001). Self-reported responsibilities with regard to IUC management by nurses and physicians changed only slightly over time. Perception of current practices and culture in regard to safe urinary catheter use increased significantly (T: 5.3, T: 5.5; p<0.001). Significant changes were also observed for determinants of behaviour (T: 5.3, T: 5.6; p<0.001).
CONCLUSION We found small but significant changes in staff perceptions after implementation of an evidence-based intervention bundle. Efforts now need to be targeted at sustaining and reinforcing these changes, so that restrictive use of IUCs becomes an integral part of the hospital culture.

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Additional indexing

Contributors:Safe Urinary Catheterization Collaboration Group
Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Infectious Diseases
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:28 October 2019
Deposited On:31 Oct 2019 13:54
Last Modified:31 Oct 2019 13:56
Publisher:BMJ Publishing Group
ISSN:2044-6055
OA Status:Gold
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1136/bmjopen-2018-028740
PubMed ID:31662357

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