Patient Engagement to Counter Catheter-associated urinary tract infections with an App (PECCA): a multicentre, prospective, interrupted time series and before-and-after study
Abstract
BACKGROUND
The risk of urinary tract infections is increased by unnecessary placement and prolonged use of urinary catheters. We aimed 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 emails and support rounds for staff members. Data on catheter use and infections were collected during a 6-month baseline and a 6-month intervention period on 13 wards in 4 hospitals in the Netherlands. Dutch Trial Register: NL7178.
FINDINGS
Between 25 June 2018 and 1 August 2019, 6,556 patients were included in 24 point-prevalence surveys, 3,285(50%) at baseline and 3,271(50%) during the intervention. During the intervention 249 app users and a median of 7 new app users per week were registered (IQR 5.5-13.0). At baseline, inappropriate catheter use was registered for 175 (21.9%) of 798 catheters, compared to 55 (7.0%) of 786 during the intervention. Time series analysis showed a non-significant decrease of inappropriate use of 5.8% (95%CI -3.76 to 15.45, p=0.219), with an odds ratio of 0.27 (0.19 - 0.37, p<0.001). Catheter-associated UTI decreased by 3.0% (1.3 - 4.6, p=0.001), with OR 0.541(0.408-0.716, p<0.001).
CONCLUSION
Although UTI significantly decreased after the implementation, we found that patient…
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