Reducing urinary catheter use: a randomised controlled study on the efficacy of an electronic reminder system in hospitalized patients

INTERVENTION: The CATH TAG is an electronic device that adhesively attaches to the catheter bag. It has a non‐intrusive green light that flashes intermittently for a period of 24 hours upon activation. After 24 hours the green flashing light changes to red, flashing with increased rapidity and visibility. The light will flash red for 4 hours and subsequently change back to green, slower flashing, restarting the cycle. The red flashing light is an indication for the nurse to reassess the need for a urinary catheter and remove it when it is no longer required. This circle will continue for 10 days and then change permanently to the red flashing light to indicate that the battery of the CATH TAG is exhausted. There is no option for nurses to manipulate the flashing light or amend the circle. CONDITION: Catheter associated asymptomatic bacteriuria Uinrary catheter usage PRIMARY OUTCOME: Duration of catheterisation (defined as the mean duration of catheterisation, calculated from the number of days from insertion of catheter to censor date). Perceptions of nurses about ease of use of the CATH TAG. This will be assessed by means of an anonymous online survey, as well as through a focus group. The survey has been designed specifically for this study. SECONDARY OUTCOME: Perceptions of nurses about barriers to the CATH TAG working successfully in varied types of patients. This will be assessed by means of an anonymous online survey, as well as through a focus group. The survey has been designed specifically for this study. Perceptions of nurses about changes in ownership or interest by patients in catheter management. This will be assessed by means of an anonymous online survey, as well as through a focus group. The survey has been designed specifically for this study. Perceptions of nurses about the effectiveness of the CATH TAG. This will be assessed by means of an anonymous online survey, as well as through a focus group. The survey has been designed specifically for this study. The number of cases of catheter associated asymptomatic bacteriuria (CA‐ASB) per 100 catheter days. ; Number of cases of CA‐ASB will be assessed by collecting the following additional datafrom patients who have a urinary sample taken: date of specimen collection, species isolated and colony count and white cell count. The number of urinary catheters inserted per 100 patient admissions INCLUSION CRITERIA: The hospital must meet the following INCLUSION CRITERIA: 1. Must have an intensive care unit 2. Must have at least ten wards 3. More than 30,000 patient admissions per year Potential wards and units eligible for inclusion are medical wards, surgical wards and intensive care units. All hospitalized patients, admitted to a ward eligible for inclusion in the study, who require a urinary catheter as part of their usual care will be included in the study. All nurses, who have worked on an intervention ward (i.e. who have worked with the CATH TAG), will be invited to participate in the survey and focus group.