Evaluating Nine-Year Sustainability After Implementing Evidence-Based Practices to Prevent Urinary Tract Infections and Overfilling of the Bladder in Patients With Hip Fracture

NCT06893562 | Completed

• 1 other identifier: 2025-00397-01
• Study Type: observational
• Target: 750
• Locations: 1 country
• Sites: 1

Brief Summary

This study focuses on evaluating the long-term sustainability of a urinary catheter care bundle designed to prevent urinary tract infections and bladder distension in patients undergoing surgery for hip fractures. The intervention, which included two key innovations-a urinary catheter certificate and a nurse-driven urinary catheter protocol, was implemented between 2015 and 2020 and successfully reduced urinary tract infections and bladder distension, previously published. However, due to the pandemic, the initiative was paused and had to be reintroduced in 2022. Now, the study aims to assess the effectiveness of these preventive measures 9 years after their initial implementation. The research will analyze changes in the incidence of urinary tract infections, bladder distension, catheterisation methods, and documentation practices in patients aged 65 and older. The findings will help inform healthcare policies and may have broader implications for preventing adverse events in other surgical patient groups

Conditions

Adherence; Documentation Skill; Sustainability of Innovations; Hip Fracture; UTI - Urinary Tract Infection; Urinary Catheters; Urinary Retention

Keywords

Sustainability of Innovations; Hip fracture; Urinary Retention; Catheter Associated Urinary Tract Infection

Outcome Measures

Primary Outcomes (1)

• Describe changes in the incidence of in-hospital urinary catheter-associated infections; Year 9 will be compared with previously published data from Years 1-5

  Definition: Urinary tract infection with onset on day 3 after admission with prior urinary catheterisation. A physician prescribed antimicrobial agents for a urinary tract infection during the hospital stay. Data will be collected from patients' medical records. Logistic regression analysis will be performed

  For one year

Secondary Outcomes (4)

• Changes in the incidence of in-hospital acquired bladder distension will be compared; Year 9 will be compared to previously published data from Years 1-5.

  For one year.

• Changes in urine volume of 500ml and more during hospital stay. Year nine will be compared yera 1-5, previous published data

  For one year

• Changes in catheterization methods during the hospital stay will be compared, with data from Year 9 compared to previously published data from Years 1-5

  For one year

• Changes in urinary catheter-related documentation in Year 9 will be compared to previously published data from Years 1-5.

  For one year

Study Arms (1)

Patients undergoing hip fracture surgery year nine after the intervention started.

Behavioral: Safe Hands and Safe Bladder intervention

Interventions

Safe Hands and Safe Bladder intervention BEHAVIORAL

Evaluating changes in urinary tract infections and bladder distension nine-year after implementing preventive measures

Patients undergoing hip fracture surgery year nine after the intervention started.

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients aged 65 years and older undergoing hip fracture surgery at a university hospital in Sweden.

You may qualify if:

• Hip fracture surgery at the study site, age 65 years and older and cared for in the ortho-geriatric wards.

You may not qualify if:

• No catheterisation during hospital stay

Sponsors & Collaborators

• Sahlgrenska University Hospital: lead

Study Sites (1)

Sahlgrenska Academy, Sahlgrenska University hospital/Mölndal

Mölndal, Västra Götaland County, 43180, Sweden

Location

Related Publications (5)

• Erichsen Andersson A, Gillespie BM, Karlsson M, Malchau H, Nellgard B, Wikstrom E, Rogmark C, Tillander J. Reduction of early surgical site and other care related infections in 3553 hip fracture patients: lessons learned from the 5-year Safe Hands project. Antimicrob Resist Infect Control. 2022 Sep 5;11(1):113. doi: 10.1186/s13756-022-01153-4.

  PMID: 36064457 BACKGROUND

• Wikstrom E, Dellenborg L, Wallin L, Gillespie BM, Erichsen Andersson A. The Safe Hands Study: Implementing aseptic techniques in the operating room: Facilitating mechanisms for contextual negotiation and collective action. Am J Infect Control. 2019 Mar;47(3):251-257. doi: 10.1016/j.ajic.2018.08.024. Epub 2018 Nov 16.

  PMID: 30449454 BACKGROUND

• Erichsen Andersson A, Frodin M, Dellenborg L, Wallin L, Hok J, Gillespie BM, Wikstrom E. Iterative co-creation for improved hand hygiene and aseptic techniques in the operating room: experiences from the safe hands study. BMC Health Serv Res. 2018 Jan 4;18(1):2. doi: 10.1186/s12913-017-2783-1.

  PMID: 29301519 BACKGROUND

• Frodin M, Nellgard B, Rogmark C, Gillespie BM, Wikstrom E, Andersson AE. A co-created nurse-driven catheterisation protocol can reduce bladder distension in acute hip fracture patients - results from a longitudinal observational study. BMC Nurs. 2022 Oct 12;21(1):276. doi: 10.1186/s12912-022-01057-z.

  PMID: 36224550 BACKGROUND

• Frodin M, Ahlstrom L, Gillespie BM, Rogmark C, Nellgard B, Wikstrom E, Erichsen Andersson A. Effectiveness of implementing a preventive urinary catheter care bundle in hip fracture patients. J Infect Prev. 2022 Mar;23(2):41-48. doi: 10.1177/17571774211060417. Epub 2022 Feb 15.

  PMID: 35340925 BACKGROUND

MeSH Terms

Conditions

Urinary Retention; Hip Fractures; Urinary Tract Infections

Condition Hierarchy (Ancestors)

Urination Disorders; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases; Femoral Fractures; Fractures, Bone; Wounds and Injuries; Hip Injuries; Leg Injuries; Infections

Study Officials

• Annette Erichsen, Associate Professor

  Gothenburg University, Sahlgrenska University Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: March 11, 2025
• First Posted: March 25, 2025
• Study Start: May 5, 2025
• Primary Completion: October 30, 2025
• Study Completion: October 30, 2025
• Last Updated: March 25, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

SE (1)