What is the evidence for interventions to prevent catheter associated urinary tract infections?

Posted on April 14, 2014 by Amy

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.)

Summary: Urethral Catheter (Indwelling Short-Term): Urinary Tract Infection Prevention. Jahan, Nasreen. Joanna Briggs Evidence Summaries. AN: JBI594. 2013.

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.

What interventions are effective at reducing readmission rate for patients with heart failure recently discharged from the hospital?

Posted on April 12, 2014 by Amy

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

Native Americans and sexual assualt/intimate partner violence

Posted on April 4, 2014 by Lisa

Bryant Davis, Thema, et al. “From the margins to the center: ethnic minority women and the mental health effects of sexual assault.” Trauma, violence & abuse 10.4 (2009):330-357.

Oetzel, John, and BonnieDuran. “Intimate partner violence in American Indian and/or Alaska Native communities: a social ecological framework of determinants and interventions.” American Indian and Alaska native mental health research 11.3 (2004):49-68.

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.

What has been written on early removal of urinary catheters in surgical patients during the last five years?

Posted on April 3, 2014 by Lisa

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.

What does recent research say about kangaroo care (aka skin to skin care) after cesarean delivery?

Posted on March 25, 2014 by Lisa

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

What is the evidence on the benefits and outcomes of kangaroo care (aka skin to skin care) in the neonatal intensive care unit (NICU)?

Posted on March 25, 2014 by Lisa

Five articles were found in PubMed that are either a systematic review or meta-analysis.

Conde-Agudelo A, Belizán JM, Diaz-Rossello J. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database Syst Rev. 2016 Aug 23;(8):CD002771. doi: 10.1002/14651858.CD002771.pub4.

McCall EM, Alderdice F, Halliday HL, Jenkins JG, Vohra S. Interventions to prevent hypothermia at birth in preterm and/or low birthweight infants. Cochrane Database Syst Rev. 2010 Mar 17;(3):CD004210.

Renfrew MJ, Craig D, Dyson L, McCormick F, Rice S, King SE, Misso K, Stenhouse E, Williams AF. Breastfeeding promotion for infants in neonatal units: a systematic review and economic analysis. Health Technol Assess. 2009 Aug;13(40):1-146, iii-iv.

McInnes RJ, Chambers J. Infants admitted to neonatal units–interventions to improve breastfeeding outcomes: a systematic review 1990-2007. Matern Child Nutr. 2008 Oct;4(4):235-63.

Smith KM. Sleep and kangaroo care: clinical practice in the newborn intensive care unit: where the baby sleeps…J Perinat Neonatal Nurs. 2007 Apr-Jun;21(2):151-7.

A search within Joanna Briggs for “kangaroo mother care low birth” will find the following two items.

Kangaroo Mother Care: Low Birth Weight Infants. [Recommended Practices]. AN: JBI6047. Year of Publication: 2013.

Hitch, Danielle. Kangaroo Mother Care: Low Birth Weight Infants. [Evidence Summaries]. AN: JBI6046. Year of Publication: 2013.

Updated link to Cochrane systematic review 10/12/2017 ldt

Is there evidence of pain management in cancer patients due to specific opioid restrictions?

Posted on March 23, 2014 by carolynmbrown

Dynamed presents an overview on current evidence in an entry for Opioids for Chronic Cancer Pain.
More information is provided for specific opioids, recommendations, and guidelines; also included are links to specific review articles.

See Joanna Briggs Institute EBI Database evidence summaries:

Cancer Patients: Pain Control (Management Principles). Susan Slade. [Evidence Summaries]. AN: JBI1758. 2016

Pain management (older individuals): Intermittent Subcutaneous Analgesics. Dao Le, Long Khanh. [Evidence Summaries]. AN: JBI1142. 2017

Cancer Patients: Pain Control (Treatment with Opioid drugs). Obeid, Stephanie. [Evidence Summaries]. AN: JBI1759. 2016

Updated links for entries in Joanna Briggs, 10/16/2017 ldt

Evidence Matters

Evidence-based information for Emory