Kunnskapsgrunnlaget - Håndbok for forebygging av kateterassosierte urinveisinfeksjoner
Oppdatert
Følgende kunnskapsgrunnlag er benyttet i utarbeidelsen av Håndbok for forebygging av kateterassosierte urinveisinfeksjoner:
Om kunnskapsgrunnlaget
Flere anerkjente, kjente aktører innen smittevern har de seneste årene publisert omfattende kunnskapsbaserte retningslinjer for forebygging av kateterassosierte urinveisinfeksjoner.1-11
Myndighetene i flere land, eksempelvis Australia, Skottland og Irland,12-15 har også publisert kunnskapsbaserte retningslinjer om emnet, likeledes European Association of Urology Nurses og European Association of Urology.16, 17
Det ble derfor ved arbeidets oppstart besluttet å bygge anbefalingene på eksisterende, kvalitetssikrede retningslinjer og systematiske oppsummeringer, fremfor gjennomgang av primærstudier.
For å identifisere eksisterende retningslinjer og systematiske oppsummeringer på området ble det gjennomført søk i aktuelle helsefaglige databaser, samt på hjemmesidene til kjente aktører innen smittevern og i elektroniske oversikter over eksisterende retningslinjer.
Søk i elektroniske databaser
Det er gjort søk i Ovid Medline, Embase, Ovid Nursing, Cochrane og Johanna Briggs Institute etter retningslinjer og systematiske oppsummeringer skrevet på engelsk, norsk, svensk eller dansk etter 2005. Relevante artikler ble kvalitetsvurdert etter prinsippene i kunnskapssenterets sjekklister for evaluering av fagartikler.18 Det ble også gjennomført håndsøk i referanselister. Søkestrategier fra Ovid databasene fremkommer i tabell 1.
|
Søketermer |
Embase* |
OvidMEDLINE (R)** (03.02.12) |
Ovid Nursing Full Text Plus (03.02.12) |
|
|
1 |
UTI.m_titl. |
415 |
241 |
44 |
|
2 |
CAUTI.m_titl. |
9 |
4 |
10 |
|
3 |
"urinary tract infection*".m_titl. |
13079 |
10239 |
507 |
|
4 |
"catheter*".m_titl. |
47815 |
42196 |
4024 |
|
5 |
"infect*".m_titl. |
438398 |
397203 |
13397 |
|
6 |
4 and 5 |
3119 |
2568 |
592 |
|
7 |
"urinary*".m_titl. |
95419 |
87444 |
3246 |
|
8 |
5 and 7 |
16192 |
13310 |
618 |
|
9 |
1 or 2 or 3 or 6 or 8 |
19049 |
15585 |
1077 |
|
10 |
"prevent*".m_titl. |
216936 |
187943 |
15077 |
|
11 |
"elimin*".m_titl. |
21132 |
19608 |
548 |
|
12 |
(infect* adj2 control*).m_titl. |
5687 |
5240 |
1949 |
|
13 |
10 or 11 or 12 |
243235 |
212291 |
17432 |
|
14 |
(guide* or strateg* or recommend* or compendium* or program* or review* or examinat* or advice* or best practice*).m_titl. |
655140 |
567052 |
68754 |
|
15 |
9 and 13 |
1109 |
928 |
205 |
|
16 |
limit 15 to ("reviews (best balance of sensitivity and specificity)" and (danish or english or norwegian or swedish) and yr="2005 -Current") |
113 |
85 |
13 |
|
17 |
9 and 13 and 14 |
146 |
121 |
41 |
|
18 |
limit 17 to ((danish or english or norwegian or swedish) and yr="2005 -Current") |
72 |
61 |
26 |
|
19 |
16 or 18 |
148 |
123 |
36 |
|
|
Artikler som omhandlet UVI |
58 |
55 |
15 |
|
|
Artikler inkludert i kunnskapsgrunnlaget |
12 (ref:2, 5, 19-28) |
11 (ref:2, 5, 20-28) |
5 (ref:5, 20, 21, 26, 28) |
* Embase 1980 to 2012 Week 04
**Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R) 1946 to Present
I Cochrane ble det søkt etter relevante Cochrane oversiktsartikler og andre oversiktsartikler med følgende søkestrategi:
Av 23 identifiserte Cochrane oversiktsartikler og 38 oversiktsartikler identifisert fra andre kilder ble 11 inkludert i kunnskapsgrunnlaget.29-39 På nettsiden til Johanna Briggs Institute ble det søkt etter relevante publikasjoner med søkeordene: urinary tract infection, urinary catheter, UTI og CAUTI. En oversiktsartikkel og en retningslinje (”Best Practice Sheet”) ble identifisert og inkludert i kunnskapsgrunnlaget.40, 41
Søk på nettsteder til aktører innen smittevern
Det ble søkt på nettstedene til kjente internasjonale aktører innen smittevern for å identifisere gjeldende retningslinjer for forebygging av helsetjenesteassosierte UVI. Følgende nettsteder ble undersøkt februar-mai 2012:
- Agency for Healthcare Research and Quality (AHRQ)
- Australian Infection Control Association (AICA)
- Centers for Disease Control and Prevention (CDC)
- European Centre for Disease Prevention and Control (ECDC)
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID)
- Healthcare Infection Society (HIS)
- Infection Prevention Society (IPS)
- International Federation of Infection Control (IFIC)
- Nasjonalt folkehelseinstitutt (FHI)
- Nasjonalt kunnskapssenter for helsetjenesten
- National Health Service (NHS)
- Smittskyddsinstitutet (Smi)
- Society for healthcare epidemiology of America (SHEA)
- Statens Serum Institut (SSI)
- The Association for Professionals in Infection Control and Epidemiology (APIC)
- The Infectious Diseases Society of America (IDSA)
- UK Department of Health
- World Health Organization (WHO)
Totalt ble 19 av publikasjonene som ble identifisert via nettstedene inkludert i kunnskapsgrunnlaget.2-11, 17, 19, 21, 24, 42-46
Søk i elektroniske oversikter over publiserte retningslinjer
Med utgangspunkt i helsebiblioteket ble det søkt i kjente elektroniske oversikter over eksisterende retningslinjer. Følgende oversikter ble undersøkt:
- Helsebiblioteket
- Guideline Advisory Committee (GAC)
- National Institute for Health and Care Excellence (NICE)
- National Guideline Clearinghouse (NGC)
- Guidelines International Network (GIN)
- National Library of Health
Totalt ble tre av publikasjonene som ble identifisert via de elektroniske oversikter over eksisterende retningslinjer inkludert i kunnskapsgrunnlaget.2, 21, 47
Enkelte av publikasjonene som er tatt med i håndbokens kunnskapsgrunnlag (litteraturliste) er ikke inkludert i hoveddokumentets referanseliste. Det er valgt å beholde dem i litteraturlisten da de belyser anbefalingene i nøkkelpublikasjonene veilederen bygger på.
Anbefalingene i håndboken er gitt uten gradering av kunnskapsgrunnlaget. Mitchell et. al19og Conway et. al48 gir imidlertid en god oversikt over graderingene slik de fremstår i de fleste av nøkkelreferansene som anbefalingene i håndboken bygger på. Graderingene er også godt beskrevet i den enkelte nøkkelreferanse.1, 2, 6, 10, 24
Litteraturliste
- Gould CV, Umscheid CA, Agarwal RK, Kuntz G, Pegues DA, Healthcare Infection Control Practices advisory Committee (HICPAC). Guideline for prevention of catheter-associated urinary tract infections 2009. HICPAC, 2009.
- Hooton TM, Bradley SF, Cardenas DD et al. Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America. Clin Infect Dis 2010;50(5):625-663.
- Greene L, Marx J, Oriola S. Guide to the Elimination of Catheter-Associated Urinary Tract Infections (CAUTIs). Developing and Applying Facility-Based Prevention Interventions in Acute and Long-Term Care Settings. APIC, 2008.
- Smith PW, Bennett G, Bradley S et al. SHEA/APIC guideline: infection prevention and control in the long-term care facility, July 2008. Infect Control Hosp Epidemiol 2008;29(9):785-814.
- Lo E, Nicolle L, Classen D et al. Strategies to prevent catheter-associated urinary tract infections in acute care hospitals. Infect Control Hosp Epidemiol 2008;29 Suppl 1:S41-S50.
- Yokoe DS, Mermel LA, Anderson DJ et al. A compendium of strategies to prevent healthcare-associated infections in acute care hospitals. Infect Control Hosp Epidemiol 2008;29 Suppl 1:S12-S21.
- Nicolle LE. Urinary tract infections in long-term-care facilities. Infect Control Hosp Epidemiol 2001;22(3):167-175.
- Damani N. The IFIC Basic Concepts of Infection Control (2011). International Federation of Infection Control, 2012.
- Pratt RJ, Pellowe C, Loveday HP et al. The epic Project: Developing National Evidence-based Guidelines for Preventing Healthcare associated Infections. Guidelines for preventing infections associated with the insertion and maintenance of short-term indwelling urethral catheters in acute care. J Hosp Infect 2001;2001(47 (supplement)):39-46.
- Pratt RJ, Pellowe CM, Wilson JA et al. epic2: National evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. J Hosp Infect 2007;65 Suppl 1:S1-64.
- National Institute for Health and Clinical Excellence . Infection. Prevention and control of healthcare-associated infections in primary and community care. National Institute for Health and Clinical Excellence, 2012. NICE clinical guideline 139.
- Health Protection Scotland, National Services Scotland. Targeted literature review: What are the key infection prevention and control recommendations to inform a urinary catheter maintenance care quality improvement tool? Health Protection Scotland, National Services Scotland, Version 1, April 2012.
- Health Protection Scotland, National Services Scotland. Targeted literature review: What are the key infection prevention and control recommandations to inform a urinary catheter insertion quality improvement tool? Health Protection Scotland, National Services scotland,Version 1, April 2012.
- The Strategy for the Control of Antimicrobial Resistance in Irland (SARI). Guidelines for the Prevention of Catheter-associated Urinary Tract Infection. Health Protection Surveillance centre, 2011.
- Australian guidelines for the prevention and control of infection in healthcare. National health and medical research council (NHMRC). Commonwealth of Australia, 2010.
- Geng V, Cobussen-Boekhorst H, Farrell J et al. Evidence-based Guidelines to Best Practice in Urological Health Care. Catheterisation. Indwelling catheters in adults. Urethral and Suprapubic. European association of Urology Nurses, 2012.
- Grabe M, Bjerklund-Johansen TE, Botto H et al. Guidelines on Urological Infections. European Association of Urology, 2011.
- Nasjonalt kunnskapssenter for helsetjenesten. Sjekklister for vurdering av forskningsartikler. http://www.kunnskapssenteret.no/ (12.12.2012).
- Mitchell B, Ware C, McGregor A et al. ASID (HICSIG)/AICA Position Statement: Preventing catheter-associated urinary tract infections in patients. Healthcare Infection 2011;16(2):45-52.
- Rebmann T, Greene LR. Preventing catheter-associated urinary tract infections: An executive summary of the Association for Professionals in Infection Control and Epidemiology, Inc, Elimination Guide. Am J Infect Control 2010;38(8):644-646.
- Gould CV, Umscheid CA, Agarwal RK, Kuntz G, Pegues DA. Guideline for prevention of catheter-associated urinary tract infections 2009. Infect Control Hosp Epidemiol 2010;31(4):319-326.
- Hameed A, Chinegwundoh F, Thwaini A. Prevention of catheter-related urinary tract infections. Br J Hosp Med (Lond) 2010;71(3):148-2.
- Shuman EK, Chenoweth CE. Recognition and prevention of healthcare-associated urinary tract infections in the intensive care unit. Crit Care Med 2010;38(8 Suppl):S373-S379.
- Tenke P, Kovacs B, Bjerklund Johansen TE, Matsumoto T, Tambyah PA, Naber KG. European and Asian guidelines on management and prevention of catheter-associated urinary tract infections. Int J Antimicrob Agents 2008;31 Suppl 1:S68-S78.
- Regal RE, Pham CQ, Bostwick TR. Urinary tract infections in extended care facilities: preventive management strategies. Consult Pharm 2006;21(5):400-409.
- Godfrey H, Fraczyk L. Preventing and managing catheter-associated urinary tract infections. Br J Community Nurs 2005;10(5):205-212.
- Trautner BW, Hull RA, Darouiche RO. Prevention of catheter-associated urinary tract infection. Curr Opin Infect Dis 2005;18(1):37-41.
- Gould CV, Umscheid CA, Agarwal RK, Kuntz G, Pegues DA, Healthcare Infection Control Practices Advisory Committee. Guideline for prevention of catheter-associated urinary tract infections 2009. Infect Control Hosp Epidemiol 2010;31(4):319-326.
- Niel-Weise BS, van den Broek PJ. Urinary catheter policies for short-term bladder drainage in adults. Cochrane Database Syst Rev 2005;(3):CD004203.
- Hagen S, Sinclair L, Cross S. Washout policies in long-term indwelling urinary catheterisation in adults. Cochrane Database Syst Rev 2010;(3):CD004012.
- Niel-Weise BS, van den Broek PJ. Urinary catheter policies for long-term bladder drainage. Cochrane Database Syst Rev 2005;(1):CD004201.
- Jahn P, Preuss M, Kernig A, Seifert-Huhmer A, Langer G. Types of indwelling urinary catheters for long-term bladder drainage in adults. Cochrane Database Syst Rev 2007;(3):CD004997.
- Phipps S, Lim YN, McClinton S, Barry C, Rane A, N'Dow J. Short term urinary catheter policies following urogenital surgery in adults. Cochrane Database Syst Rev 2006;(2):CD004374.
- Johnson JR, Kuskowski MA, Wilt TJ. Systematic review: antimicrobial urinary catheters to prevent catheter-associated urinary tract infection in hospitalized patients. Ann Intern Med 2006;144(2):116-126.
- Meddings J, Rogers MA, Macy M, Saint S. Systematic review and meta-analysis: reminder systems to reduce catheter-associated urinary tract infections and urinary catheter use in hospitalized patients. Clin Infect Dis 2010;51(5):550-560.
- Saint S, Elmore JG, Sullivan SD, Emerson SS, Koepsell TD. The efficacy of silver alloy-coated urinary catheters in preventing urinary tract infection: a meta-analysis. Am J Med 1998;105(3):236-241.
- van den Eijkel E, Griffiths P. Catheter valves for indwelling urinary catheters: a systematic review. Br J Community Nurs 2006;11(3):111-2, 114.
- Palese A, Buchini S, Deroma L, Barbone F. The effectiveness of the ultrasound bladder scanner in reducing urinary tract infections: a meta-analysis. J Clin Nurs 2010;19(21-22):2970-2979.
- Lockwood C, Page T, Conroy-Hiller T, Florence Z. Management of short-term indwelling urethral catheters to prevent urinary tract infections. JBI Reports 2004;2(8):271-291.
- Moola S, Konno R. A systematic review of the management of short-term indwelling urethral catheters to prevent urinary tract infections. Joanna Briggs Institute Library of Systematic Reviews 2010;8(17):695-729.
- Joanna Briggs Institute. Management of short-term indwelling urethral catheters to prevent urinary tract infections Best Practice: evidence-based information sheets for health professionals. 2010;14(12):1-4.
- Burman LG. Vårdrelaterade urinvägsinfektioner. In: Socialstyrelsen, editor. Att forebygga vardrelaterade infektioner. Ett kunskapsunderlag. Lindesberg: Socialstyrelsen; 2006:122-138.
- NHS Quality Improvement Scotland. Best Practice Statement ~ June 2004. Urinary Catheterisation & Catheter Care. NHS Quality Improvement Scotland, 2004.
- Emblem EL, Frugård J, Høisæter PÅ, Otnes B. Nasjonale retningslinjer for helsepersonell ved bruk av intermitterende kateterisering - IK. NSF`s faglige sammenslutning av sykepleiere i urologi og Norsk urologisk forening, 2005.
- Ducel G, Fabry J, Nicolle L. Prevention of hospital - acquired infections. A practical guide. 2nd edition. World Health Organization Department of Communicable Disease Surveillance and Response, 2002.
- National Institute for Health and Clinical Excellence (UK). Infection Control: Prevention of Healthcare-associated Infections in Primary and Community Care [Internet]. National Institute for Health and Clinical Excellence (UK), 2003.
- Section 3 - Urinary Catheterisation. Guidelines for preventing healthcare-associated infections during long-term urinary catheterisation in primary and community care. Infection Control: Prevention of Healthcare-associated Infections in Primary and Community Care. National Institute for Health and Clinical Excellence; 2003:98-117.
- Conway LJ, Larson EL. Guidelines to prevent catheter-associated urinary tract infection: 1980 to 2010. Heart Lung 2012;41(3):271-283.