Bottom line: Best available evidence suggests that tap water can be used to effectively clean genitalia; daily cleaning of the meatal area and early removal of catheters are associated with reduction in CAUTIs. Some evidence suggests silver-impregnated catheters associated with decreased incidence of bacteriuria. Evidence does not support use of sealed drainage systems (as a single strategy), adding antibacterial solutions to drainage bags, or routinely changing drainage bags (as opposed to changing only when clinically necessary.)
Moola S, Konno R. A systematic review of the management of shot-term indwelling urethral catheters to prevent urinary tract infections. JBI Library of Systematic Reviews. 2010;8(17): 695-729.
Review of studies retrieved from Medline and CINAHL and that included adult patients using urinary catheters 1 to 14 days. Methodologies included first RCTs. If no RCTs available, then non-randomized studies and before and after studies were included. Results section describes findings for various types of intervention strategies.
DynaMed
Heart Failure Structured Management and Education topic
Evidence regarding interventions to reduce readmission include
Systematic review of 8 RCTs compared multidisciplinary education and post-discharge follow-up intervention to usual care by physician after discharge and found that readmission rates were significantly reduced (38.4% v. 49.2%) but did not significantly reduce mortality.
Arch Intern Med 2004 Nov 22;164(21):2315
Systematic review of 18 RCTs compared programs of comprehensive discharge planning v. standard; pooled data over average of 8 months showed readmission in 34.9% of study group v. 43.2% of controls.
JAMA 2004 Mar 17;291(11):1358
Systematic review of studies of varying quality on self-management interventions
BMC Cardiovasc Disord 2006 Nov 2;6:43
Small (n=206) trial of heart failure patients randomized to nurse-run post-discharge follow-up plan versus standard post-discharge care showed reduction in readmission rate for the study group (39% v 54%) – other randomized trials showed no significant difference in readmission between control groups and nurse-management groups
Another systematic review of 21 randomized trials concluded that structured, multidisciplinary post-discharge interventions do affect readmission rate.
Other interventions covered in this DynaMed topic include telephone case management and home visits by nurses and pharmacists. See DynaMed topic above for full summary.
JBI+ COnNECT
(searched heart failure and readmission)
Systematic review of 16 RCTs evaluating effect of care transition interventions on readmission rate
Systematic review of 3 RCTs and 2 quasi-experimental studies evaluating effect of telephone interventions
Systematic review of 10 RCTs evaluating effect of specifically telephone post-discharge nursing care
For studies published since these reviews
PubMed: (“Heart Failure”[Majr]) AND “Patient Readmission”[Majr] AND prevention
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Wahab, Stephanie, and Lenora Olson. “Intimate partner violence and sexual assault in Native American communities.” Trauma, violence & abuse 5.4 (2004):353-366.
Chester, B, et al. “Grandmother dishonored: violence against women by male partners in American Indian communities.” Violence and victims 9.3 (1994):249-258.
Murphy, Miles, et al. “Postoperative management and restrictions for female pelvic surgery: a systematic review.” International urogynecology journal and pelvic floor dysfunction 24.2 (2013):185-193.
Zaouter, C, et al. “Early removal of urinary catheter leads to greater post-void residuals in patients with thoracic epidural.” Acta anaesthesiologica Scandinavica 56.8 (2012):1020-1025.
Chai, Joyce, and Ting-ChungPun. “A prospective randomized trial to compare immediate and 24-hour delayed catheter removal following total abdominal hysterectomy.” Acta obstetricia et gynecologica Scandinavica 90.5 (2011):478-482.
Mentler, Ellie, et al. “High incidence of acute urinary retention associated with immediate catheter removal after laparoscopic Nissen fundoplication.” Surgical endoscopy 25.5 (2011):1611-1616.
Huang, Chih C, et al. “Optimal duration of urinary catheterization after anterior colporrhaphy.” International urogynecology journal and pelvic floor dysfunction 22.4 (2011):485-491.
Das Bhagia S, et al. “Is it necessary to remove foleys catheter late after transurethral prostatectomy in patients who presented with acute urinary retention secondary to benign prostatic hyperplasia?” JPMA. The journal of the Pakistan Medical Association 60.9 (2010):739-741.
Kamilya, Gourisankar, et al. “A randomized controlled trial comparing short versus long-term catheterization after uncomplicated vaginal prolapse surgery.” Journal of obstetrics and gynaecology research 36.1 (2010):154-158.
Chia, Yuan-Yi, et al. “Optimal duration of urinary catheterization after thoracotomy in patients under postoperative patient-controlled epidural analgesia. Acta anaesthesiologica Taiwanica 47.4 (2009):173-179.
Zaouter, Cedrick, PepaKaneva, and FrancoCarli. “Less urinary tract infection by earlier removal of bladder catheter in surgical patients receiving thoracic epidural analgesia.” Regional anesthesia and pain Medicine 34.6 (2009):542-548.
de Moya, Marc A, et al. “Colovesical fistula repair: is early Foley catheter removal safe?” The Journal of surgical research 156.2 (2009):274-277.
Ozu, Choichiro, et al. “Radical retropubic prostatectomy with running vesicourethral anastomosis and early catheter removal: our experience.” International journal of urology 16.5 (2009):487-492.
Sekhavat, Leila, TahminahFarajkhoda, and RobabDavar. “The effect of early removal of indwelling urinary catheter on postoperative urinary complications in anterior colporrhaphy surgery.” The Australian and New Zealand journal of obstetrics and gynaecology 48.3 (2008):348-352.
Moore ER, Anderson GC, Bergman N, Dowswell T. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev. 2016 Nov 25;11:CD003519.
Crenshaw JT, Cadwell K, Brimdyr K, Widström AM, Svensson K, Champion JD, Gilder RE, Winslow EH. Use of a video-ethnographic intervention (PRECESS Immersion Method) to improve skin-to-skin care and breastfeeding rates. Breastfeed Med. 2012 Apr;7(2):69-78.
Velandia M, Uvnäs-Moberg K, Nissen E. Sex differences in newborn interaction with mother or father during skin-to-skin contact after Caesarean section. Acta Paediatr. 2012 Apr;101(4):360-7.
Hung KJ, Berg O. Early skin-to-skin after cesarean to improve breastfeeding. MCN Am J Matern Child Nurs. 2011 Sep-Oct;36(5):318-24; quiz 325-6.
Gouchon S, Gregori D, Picotto A, Patrucco G, Nangeroni M, Di Giulio P. Skin-to-skin contact after cesarean delivery: an experimental study. Nurs Res. 2010 Mar-Apr;59(2):78-84.
Nolan A, Lawrence C. A pilot study of a nursing intervention protocol to minimize maternal-infant separation after Cesarean birth. J Obstet Gynecol Neonatal Nurs. 2009 Jul-Aug;38(4):430-42.
Erlandsson K, Dsilna A, Fagerberg I, Christensson K. Skin-to-skin care with the father after cesarean birth and its effect on newborn crying and prefeeding behavior. Birth. 2007 Jun;34(2):105-14.
Updated link for Cochrane systematic review 10/12/2017 ldt
Evidence Matters 