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 Raphaël; Kuster, Stefan P; Schwappach, David LB

doi:10.1136/bmjopen-2018-028740

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Title		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
Authors		Niederhauser, Andrea Züllig, Stephanie Marschall, Jonas Schweiger, Alexander John, Gregor Raphaël Kuster, Stefan P Schwappach, David LB
Collaboration		progress! Safe Urinary Catheterization Collaboration Group
Published in		BMJ Open. 2019, vol. 9, no. 10, p. 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 (T0) (49% response rate) and 1527 participated in the followup survey (T1) (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 (T0: 10.4, T1: 11.0; p<0.001). Selfreported 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 (T0: 5.3, T1: 5.5; p<0.001). Significant changes were also observed for determinants of behaviour (T0: 5.3, T1: 5.6; p<0.001). Conclusion We found small but significant changes in staff perceptions after implementation of an evidencebased 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.
Identifiers		DOI: 10.1136/bmjopen-2018-028740
Full text		Article (Published version) (410 Kb) - Free access Other version: http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-028740
Structures		Faculté de médecine / Section de médecine clinique / Département de médecine
Project		Swiss Federal Office of Public Health (no 15.011083)
Citation (ISO format)		NIEDERHAUSER, Andrea et al. 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. In: BMJ Open, 2019, vol. 9, n° 10, p. e028740. doi: 10.1136/bmjopen-2018-028740 https://archive-ouverte.unige.ch/unige:125258