Fourteen studies were included: 12 pre-post intervention studies (three of which also included a control group), one randomised trial and one non-randomised crossover trial. Reported sample sizes ranged from 50 to 6,297 patients. Follow-up ranged from five days to 30 months. None of the studies were reportedly funded by industry.
The number of CAUTI episodes was significantly reduced following either reminder or stop order interventions (RR 0.48, 95% CI 0.28 to 0.68, I2=79%; seven studies).
Sensitivity analysis revealed heterogeneity only in the reminder intervention analysis (I2=84%). Analyses of studies that used cointerventions and analyses that explored the effects of removal of individual studies yielded similar results.
Risk reduction was greater in studies of non-intensive care unit patients (RR 0.27, 95% CI 0.17 to 0.37; four studies) than in studies of intensive care unit patients (RR 0.67, 95% CI 0.55 to 0.80; three studies).
Stop order interventions significantly reduced the mean number of days of urinary catheter use (SMD -0.30, 95% CI -0.48 to -0.12, I2=51%; three studies), but reminder interventions did not (five studies, I2=99.9%).