PMID- 30359646
DCOM- 20190813
LR  - 20190813
IS  - 1532-2939 (Electronic)
IS  - 0195-6701 (Linking)
VI  - 102
IP  - 2
DP  - 2019 Jun
TI  - Effectiveness of behavioural interventions to reduce urinary tract infections and
      Escherichia coli bacteraemia for older adults across all care settings: a
      systematic review.
PG  - 200-218
LID - S0195-6701(18)30548-6 [pii]
LID - 10.1016/j.jhin.2018.10.013 [doi]
AB  - BACKGROUND: Escherichia coli bacteraemia rates in the UK have risen; rates are
      highest among older adults. Previous urinary tract infections (UTIs) and
      catheterization are risk factors. AIM: To examine effectiveness of behavioural
      interventions to reduce E. coli bacteraemia and/or symptomatic UTIs for older
      adults. METHODS: Sixteen databases, grey literature, and reference lists were
      searched. Titles and/or abstracts were scanned and selected papers were read
      fully to confirm suitability. Quality was assessed using Critical Appraisal
      Skills Programme guidelines and Scottish Intercollegiate Guidelines Network
      grading. FINDINGS: Twenty-one studies were reviewed, and all lacked
      methodological quality. Six multi-faceted hospital interventions including
      education, with audit and feedback or reminders reduced UTIs but only three
      supplied statements of significance. One study reported decreasing
      catheter-associated UTI (CAUTI) by 88% (F (1,20) = 7.25). Another study reported 
      reductions in CAUTI from 11.17 to 10.53 during Phase I and by 0.39 during Phase
      II (chi(2) = 254). A third study reported fewer UTIs per patient week (risk ratio
      = 0.39). Two hospital studies of online training and catheter insertion and care 
      simulations decreased CAUTIs from 33 to 14 and from 10.40 to 0. Increasing
      nursing staff, community continence nurses, and catheter removal reminder
      stickers reduced infection. There were no studies examining prevention of E. coli
      bacteraemias. CONCLUSION: The heterogeneity of studies means that one effective
      intervention cannot be recommended. We suggest that feedback should be considered
      because it facilitated reductions in UTI when used alone or in multi-faceted
      interventions including education, audit or catheter removal protocols.
      Multi-faceted education is likely to be effective. Catheter removal protocols,
      increased staffing, and patient education require further evaluation.
CI  - Crown Copyright (c) 2018. Published by Elsevier Ltd. All rights reserved.
FAU - Jones, L F
AU  - Jones LF
AD  - Public Health England, Gloucester, UK.
FAU - Meyrick, J
AU  - Meyrick J
AD  - University of the West of England, Bristol, UK.
FAU - Bath, J
AU  - Bath J
AD  - University of the West of England, Bristol, UK.
FAU - Dunham, O
AU  - Dunham O
AD  - University of the West of England, Bristol, UK.
FAU - McNulty, C A M
AU  - McNulty CAM
AD  - Public Health England, Gloucester, UK. Electronic address:
LA  - eng
PT  - Journal Article
PT  - Systematic Review
DEP - 20181022
PL  - England
TA  - J Hosp Infect
JT  - The Journal of hospital infection
JID - 8007166
MH  - Aged
MH  - Aged, 80 and over
MH  - Bacteremia/*prevention & control
MH  - Behavior Therapy/*methods
MH  - Escherichia coli Infections/*prevention & control
MH  - Female
MH  - Humans
MH  - Infection Control/*methods
MH  - Male
MH  - Risk Factors
MH  - United Kingdom
MH  - Urinary Tract Infections/complications/*prevention & control
OT  - E. coli antimicrobial resistance
OT  - Interventions
OT  - Older adults
OT  - Systematic review
OT  - Urinary tract infections
EDAT- 2018/10/26 06:00
MHDA- 2019/08/14 06:00
CRDT- 2018/10/26 06:00
PHST- 2018/06/22 00:00 [received]
PHST- 2018/10/15 00:00 [accepted]
PHST- 2018/10/26 06:00 [pubmed]
PHST- 2019/08/14 06:00 [medline]
PHST- 2018/10/26 06:00 [entrez]
AID - S0195-6701(18)30548-6 [pii]
AID - 10.1016/j.jhin.2018.10.013 [doi]
PST - ppublish
SO  - J Hosp Infect. 2019 Jun;102(2):200-218. doi: 10.1016/j.jhin.2018.10.013. Epub
      2018 Oct 22.