Effects of a minimal reminder intervention to reduce the length of urinary catheterization and intravenous fluids therapy for internal medicine inpatients: a parallel controlled clinical trial

Abstract

Objective: To assess the effectiveness of a twice-weekly simple reminder intervention in shortening the duration of urinary catheterization and intravenous fluid therapy.

Methods: Design: Parallel, controlled clinical trial. Setting: Two internal medicine wards. Patients: Patients admitted to the Internal Medicine Department since October 2010 and 3, 7 and 12 months later. Intervention: A twice-weekly simple reminder intervention during the meetings of the medical-nursing team in one ward (intervention group) and no intervention in the other (control group). Measurements: Age, sex, living at home or in  a nursing residence, Barthel index, Norton scale, use and duration of urinary catheterization and intravenous fluid therapy, presence of pressure ulcers, onset of delirium, Major Diagnostic Category, and length of stay.

Results: 747 patients were included. On 265 of them (35.4%) urinary catheterization was used. Patients in control group hadurinary catheters inserted more frequently (39.1% vs. 31.7%; p = .03) and for a longer time [median (interquartile range) 5 (8) vs.4 (6) days; p = .007]; also, the catheter was left in place at discharge more frequently (15.2% vs. 10.1%; p = .04). Intravenousfluid therapy was used on 519 (69%) patients. There were no differences in use between both groups, but it was for a longerperiod in control group [4 (5) vs. 3 (5) days; p = .001].

Conclusions: A simple face-to-face intervention during the meetings of the medical-nursing team with a twice a week reminder to withdraw unnecessary urinary catheters and intravenous fluid therapy efficiently reduces the duration of such treatments.