Long-term outcome of an interventionto remove unnecessary urinary catheters, with and without a quality improvement team, in a Thai tertiary care center.

Long-term outcome of an intervention to remove unnecessary urinary catheters, with and without a quality improvement team, in a Thai tertiary care center outcome of an intervention to remove unnecessary urinary catheters, with and without a quality improvement team, in a Thai tertiary care center. JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact [email protected]. The University of Chicago Press and The Society for Healthcare Epidemiology of America are collaborating with JSTOR to digitize, preserve and extend access to Infection Control and Hospital Epidemiology. To the Editor—Several studies about reducing the rate of cath-eter-associated urinary tract infections have reported the success of interventions that were not device-based. 1-5 Two previous studies reported successful outcomes of quality improvement programs featuring interventions to remind physicians to remove unnecessary catheters. 4,5 These programs subsequently reduced the number of unnecessary urinary cathe-ter–days and decreased the rates of catheter-associated urinary tract infection. However, such interventions are labor intensive and require a long-term commitment from nursing and physician staff. In addition, the long-term effects of these programs have not been adequately explored. Whether interventions can be successful without the involvement of a quality improvement team deserves further investigation. In this letter, we report 2 years of follow-up data from a hospital-wide quality improvement program featuring an intervention to remind physicians to remove unnecessary urinary catheters, with and without the involvement of a quality improvement team, at one university-based hospital. (period 1), we implemented a hospital-wide quality improvement program featuring physician reminders to remove unnecessary urinary catheters. During this period, the nursing staff identified patients who had had a urinary catheter in place for at least 3 days by reviewing orders keyed into a computer terminal linked to the hospital central workstation, and they notified investigators of these patients. If urinary catheterization was deemed inappropriate, daily bedside discussions occurred among treating physicians and physicians from the intervention team regarding the reasons for urinary catheterization and the possibility of discontinuing it. Treating physicians then made a decision to maintain or remove the patient's catheter. The nursing staff continually monitored patients for any systemic or local sign of catheter-associated urinary tract infection, and an infectious diseases physician confirmed the appropriateness …