Patient engagement to counter catheter-associated urinary tract infections with an app (PECCA): a multicentre, prospective, interrupted time-series and before-and-after study

Bentvelsen, R.G.; Bonten, T.; Vaart, R.V.; Hetem, D.J.; Soetekouw, R.; Geerlings, S.E.; Chavannes, N.H.; Veldkamp, K.E.

doi:doi:10.1016/j.jhin.2023.11.005

Background: The risk of urinary tract infections (UTIs) is increased by unnecessary placement and prolonged use of urinary catheters. Aim: To assess whether inappropriate use of catheters and catheter-associated UTI were reduced through patient participation. Methods: In this multicentre, interrupted time-series and before-and-after study, we implemented a patient-centred app which provides catheter advice for patients, together with clinical lessons, feedback via e-mails and support rounds for staff members. Data on catheter use and infections were collected during a six-month baseline and a six-month intervention period on 13 wards in four hospitals in the Netherlands. Dutch Trial Register: NL7178. Findings: Between June 25th, 2018 and August 1st, 2019, 6556 patients were included in 24 point-prevalence surveys, 3285 (50%) at baseline and 3271 (50%) during the intervention. During the intervention 249 app users and a median of seven new app users per week were registered ...Show moreBackground: The risk of urinary tract infections (UTIs) is increased by unnecessary placement and prolonged use of urinary catheters. Aim: To assess whether inappropriate use of catheters and catheter-associated UTI were reduced through patient participation. Methods: In this multicentre, interrupted time-series and before-and-after study, we implemented a patient-centred app which provides catheter advice for patients, together with clinical lessons, feedback via e-mails and support rounds for staff members. Data on catheter use and infections were collected during a six-month baseline and a six-month intervention period on 13 wards in four hospitals in the Netherlands. Dutch Trial Register: NL7178. Findings: Between June 25th, 2018 and August 1st, 2019, 6556 patients were included in 24 point-prevalence surveys, 3285 (50%) at baseline and 3271 (50%) during the intervention. During the intervention 249 app users and a median of seven new app users per week were registered (interquartile range: 5.5e13.0). At baseline, inappropriate catheter use was registered for 175 (21.9%) out of 798 catheters, compared to 55 (7.0%) out of 786 during the intervention. Time-series analysis showed a non-significant decrease of inappropriate use of 5.8% (95% confidence interval: e3.76 to 15.45; P ¼ 0.219), with an odds ratio of 0.27 (0.19e0.37; P < 0.001). Catheter-associated UTI decreased by 3.0% (1.3e4.6; P ¼ 0.001), with odds ratio 0.541 (0.408e0.716; P < 0.001).
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Patient engagement to counter catheter-associated urinary tract infections with an app (PECCA) a multicentre, prospective, interrupted time-series and before-and-after study