Impact of Foley Catheter Placement by Medical Students on Rates of Postoperative Urinary Tract Infection

Ibrahim Sultan, Ahmet Kilic, George Arnaoutakis, Arman Kilic

Research output: Contribution to journalArticle

Abstract

Background: The aim of this study was to evaluate the impact of medical student placement of Foley catheters on rates of postoperative catheter-associated urinary tract infection (CAUTI). Study Design: We included adult surgical patients in our institutional National Surgical Quality Improvement Program (NSQIP) database, and defined CAUTI according to NSQIP criteria. A multivariable model risk-adjusting for patient and operative variables associated with CAUTI in univariate analysis (exploratory p < 0.20) evaluated the independent effect of medical student placement of Foley catheters on the odds of CAUTI. Results: There were 891 patients who had a Foley catheter placed by a surgical resident (61%; n = 547), operating room nurse (25%; n = 227), or medical student (13%; n = 117). After risk-adjustment, patients with Foleys placed by medical students were at a more than 4-fold increased risk of CAUTI (odds ratio [OR] 4.09, p = 0.02) compared with patients with catheters placed by nurses. Patients with catheters placed by residents did not have an increased risk-adjusted odds of CAUTI (OR 2.16, p = 0.15). Other significant predictors of postoperative CAUTI included female sex (OR 2.61, p = 0.01), partial/total functional dependence (OR 4.81, p = 0.008), blood transfusion (OR 34.7, p = 0.02), and increased length of Foley stay (OR 1.06, p < 0.001). Conclusions: Surgical patients with Foley catheters placed by medical students are at increased risk-adjusted odds of postoperative CAUTI. More intense supervision of medical students during urinary catheter insertion in the operating room and improved education regarding sterile technique may be important factors in reducing rates of postoperative CAUTI in academic institutions.

Original languageEnglish (US)
Pages (from-to)496-501
Number of pages6
JournalJournal of the American College of Surgeons
Volume227
Issue number5
DOIs
StatePublished - Nov 1 2018

Fingerprint

Catheter-Related Infections
Medical Students
Urinary Tract Infections
Catheters
Odds Ratio
Operating Rooms
Quality Improvement
Nurses
Risk Adjustment
Urinary Catheters
Sex Ratio
Blood Transfusion
Length of Stay
Databases
Education

ASJC Scopus subject areas

  • Surgery

Cite this

Impact of Foley Catheter Placement by Medical Students on Rates of Postoperative Urinary Tract Infection. / Sultan, Ibrahim; Kilic, Ahmet; Arnaoutakis, George; Kilic, Arman.

In: Journal of the American College of Surgeons, Vol. 227, No. 5, 01.11.2018, p. 496-501.

Research output: Contribution to journalArticle

@article{a41e2bc729e1400b912b81917450333d,
title = "Impact of Foley Catheter Placement by Medical Students on Rates of Postoperative Urinary Tract Infection",
abstract = "Background: The aim of this study was to evaluate the impact of medical student placement of Foley catheters on rates of postoperative catheter-associated urinary tract infection (CAUTI). Study Design: We included adult surgical patients in our institutional National Surgical Quality Improvement Program (NSQIP) database, and defined CAUTI according to NSQIP criteria. A multivariable model risk-adjusting for patient and operative variables associated with CAUTI in univariate analysis (exploratory p < 0.20) evaluated the independent effect of medical student placement of Foley catheters on the odds of CAUTI. Results: There were 891 patients who had a Foley catheter placed by a surgical resident (61{\%}; n = 547), operating room nurse (25{\%}; n = 227), or medical student (13{\%}; n = 117). After risk-adjustment, patients with Foleys placed by medical students were at a more than 4-fold increased risk of CAUTI (odds ratio [OR] 4.09, p = 0.02) compared with patients with catheters placed by nurses. Patients with catheters placed by residents did not have an increased risk-adjusted odds of CAUTI (OR 2.16, p = 0.15). Other significant predictors of postoperative CAUTI included female sex (OR 2.61, p = 0.01), partial/total functional dependence (OR 4.81, p = 0.008), blood transfusion (OR 34.7, p = 0.02), and increased length of Foley stay (OR 1.06, p < 0.001). Conclusions: Surgical patients with Foley catheters placed by medical students are at increased risk-adjusted odds of postoperative CAUTI. More intense supervision of medical students during urinary catheter insertion in the operating room and improved education regarding sterile technique may be important factors in reducing rates of postoperative CAUTI in academic institutions.",
author = "Ibrahim Sultan and Ahmet Kilic and George Arnaoutakis and Arman Kilic",
year = "2018",
month = "11",
day = "1",
doi = "10.1016/j.jamcollsurg.2018.08.182",
language = "English (US)",
volume = "227",
pages = "496--501",
journal = "Journal of the American College of Surgeons",
issn = "1072-7515",
publisher = "Elsevier Inc.",
number = "5",

}

TY - JOUR

T1 - Impact of Foley Catheter Placement by Medical Students on Rates of Postoperative Urinary Tract Infection

AU - Sultan, Ibrahim

AU - Kilic, Ahmet

AU - Arnaoutakis, George

AU - Kilic, Arman

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Background: The aim of this study was to evaluate the impact of medical student placement of Foley catheters on rates of postoperative catheter-associated urinary tract infection (CAUTI). Study Design: We included adult surgical patients in our institutional National Surgical Quality Improvement Program (NSQIP) database, and defined CAUTI according to NSQIP criteria. A multivariable model risk-adjusting for patient and operative variables associated with CAUTI in univariate analysis (exploratory p < 0.20) evaluated the independent effect of medical student placement of Foley catheters on the odds of CAUTI. Results: There were 891 patients who had a Foley catheter placed by a surgical resident (61%; n = 547), operating room nurse (25%; n = 227), or medical student (13%; n = 117). After risk-adjustment, patients with Foleys placed by medical students were at a more than 4-fold increased risk of CAUTI (odds ratio [OR] 4.09, p = 0.02) compared with patients with catheters placed by nurses. Patients with catheters placed by residents did not have an increased risk-adjusted odds of CAUTI (OR 2.16, p = 0.15). Other significant predictors of postoperative CAUTI included female sex (OR 2.61, p = 0.01), partial/total functional dependence (OR 4.81, p = 0.008), blood transfusion (OR 34.7, p = 0.02), and increased length of Foley stay (OR 1.06, p < 0.001). Conclusions: Surgical patients with Foley catheters placed by medical students are at increased risk-adjusted odds of postoperative CAUTI. More intense supervision of medical students during urinary catheter insertion in the operating room and improved education regarding sterile technique may be important factors in reducing rates of postoperative CAUTI in academic institutions.

AB - Background: The aim of this study was to evaluate the impact of medical student placement of Foley catheters on rates of postoperative catheter-associated urinary tract infection (CAUTI). Study Design: We included adult surgical patients in our institutional National Surgical Quality Improvement Program (NSQIP) database, and defined CAUTI according to NSQIP criteria. A multivariable model risk-adjusting for patient and operative variables associated with CAUTI in univariate analysis (exploratory p < 0.20) evaluated the independent effect of medical student placement of Foley catheters on the odds of CAUTI. Results: There were 891 patients who had a Foley catheter placed by a surgical resident (61%; n = 547), operating room nurse (25%; n = 227), or medical student (13%; n = 117). After risk-adjustment, patients with Foleys placed by medical students were at a more than 4-fold increased risk of CAUTI (odds ratio [OR] 4.09, p = 0.02) compared with patients with catheters placed by nurses. Patients with catheters placed by residents did not have an increased risk-adjusted odds of CAUTI (OR 2.16, p = 0.15). Other significant predictors of postoperative CAUTI included female sex (OR 2.61, p = 0.01), partial/total functional dependence (OR 4.81, p = 0.008), blood transfusion (OR 34.7, p = 0.02), and increased length of Foley stay (OR 1.06, p < 0.001). Conclusions: Surgical patients with Foley catheters placed by medical students are at increased risk-adjusted odds of postoperative CAUTI. More intense supervision of medical students during urinary catheter insertion in the operating room and improved education regarding sterile technique may be important factors in reducing rates of postoperative CAUTI in academic institutions.

UR - http://www.scopus.com/inward/record.url?scp=85052950262&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85052950262&partnerID=8YFLogxK

U2 - 10.1016/j.jamcollsurg.2018.08.182

DO - 10.1016/j.jamcollsurg.2018.08.182

M3 - Article

C2 - 30145285

AN - SCOPUS:85052950262

VL - 227

SP - 496

EP - 501

JO - Journal of the American College of Surgeons

JF - Journal of the American College of Surgeons

SN - 1072-7515

IS - 5

ER -