Prevalence of nosocomial urinary infection. Alternative measures to bladder catheterization

BACKGROUND: The detection of a high percentage of nosocomial urinary infection (NUI) associated with vesical catheterization (VC) and the frequent use of VC in patients with urinary incontinence, led us to implant a prevention programme which included the introduction of absorbent diapers as a alternative to vesical catheterization in incontinent patients. MATERIAL AND METHODS: After actualization and introduction of VC preventive measures and the introduction of absorbent diapers, regular determinations were made of the prevalence of NUI with analysis of the variations using the chi(2) test for trends. The prevalence of urinary incontinence and the efficacy of the diapers were also measured. RESULTS: The prevalence of NUI associated with VC showed a significant decrease, from 27.5% to 3% (p = 0.004). Between 6% and 11% of the patients admitted to the medical service had urinary incontinence. After introduction of the diapers as part of heart care assistance programme, the use of VC in patients with urinary incontinence is rare. CONCLUSIONS: 1) The prevention programme allowed a significant reduction in the prevalence of NUI associated with VC. 2) The use of absorbent diapers to care for patients with urinary incontinence probably contributed to reducing the prevalence of NUI. It was well accepted by the nursing staff and iatrogeny associated with their use was scarce.