This is a longitudinal, multi-phase, international quality improvement project, which aims to improve the quality of care provided in hospitals for adults who require the insertion or continuing management of indwelling urinary catheterization.
It will focus on enabling staff from participating hospitals to implement best practice recommendations in order to improve or sustain compliance with high quality recommendations from Clinical Practice Guidelines. The audit criteria for this project have been extracted from the CDC guideline for the prevention of catheter- associated urinary tract infections (2009). A quality assessment of the guideline resulted in a good AGREE II score for overall quality and for domain specific quality.
The clinical audit will be undertaken using specialist software (JBI PACES) that has been designed to facilitate the anonymous collection, collation, and analysis of data. The point prevalence data collected is not individual patient data; it is data about the structures and processes associated with care delivery by health care professionals.
The situational analysis phase is based on the difference between baseline compliance with best practice recommendations, and optimal compliance with best practice recommendations. During this phase of the study, the JBI PACES software will be implemented to assist sites to review their baseline data, to identify barriers to improved compliance, implement strategies that are designed to promote improved compliance, and identify relevant resources to assist with implementing evidence-based practice.
This phase will be prospective; sites will have time to embed strategies and resources at the system and clinical level within their organization and time to reinforce the implementation and sustainability of best practice in indwelling urethral catheter insertion and management for adult inpatients. The third phase will be the second point prevalence audit that utilizes the same criteria as in the baseline audit. This is an international quality improvement project, with a focus on data related to care delivery by health care practitioners. The data will be primarily drawn from healthcare professionals' documentation and will contain no patient identifiers.
UCSF Medical Center is the only participating site from the United States in this JBI-sponsored international quality improvement project.