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Project: The CATH TAG project: A multimethod evaluation of an electronic reminder system to reduce catheter associated urinary tract infections in hospital
Date: Up to date as of August 2018
Research Contact: Prof Brett Mitchell, Chief Investigator

Study Overview

The study was undertaken in one large Australian public hospital between November 2017 and May 2018.
Ethics: Approval has been obtained from the Human Research Ethics Committees Queensland Health (HREC17QTHS19) and Avondale University (2017:15).
Trial registration number: 12617001191381.


The CATH TAG study aimed to evaluate whether an electronic reminder system was effective in reducing the usage of indwelling urinary catheters and whether this electronic reminder system had an effect on nurses’ ability to deliver patient care. The overall objective of the study was to contribute to research aimed at reducing catheter-associated infections (CAUTIs).

The intervention: The CATH TAG

During the intervention period a CATH TAG was attached to every indwelling urinary catheter on ten wards in one large Australian public hospital. The CATH TAG is an electronic device in the form of a sticker. It is attached adhesively to the catheter bag. It is small and light-weight and has a non-intrusive green light that flashes intermittently (once/minute) upon activation. The alternating red and green flashing light is an indication for the nurse to reassess the ongoing need for an indwelling urinary catheter and remove it if no longer required.


The study used a mixed methods approach in which both, quantitative and qualitative data was collected. The quantitative part included a stepped wedge randomised controlled design. The qualitative part consisted of an online survey and a focus group for nurses.

What is a stepped wedge randomised controlled design?

The stepped wedge randomised controlled design means that each ward has an intervention period AND a control period. The wards are changing over to the intervention at different times. Analysis is undertaken of the change within each ward before and after the intervention. After a baseline, every 4 weeks, two wards would change over to the intervention. The wards were randomly assigned to change over to the intervention period.

Research Investigators

Brett Mitchell
Avondale University

Oyebola Fasugba
Avondale University and
Australian Catholic University

Allen C Cheng
Monash University and
Alfred Health

Philip L Russo
Avondale University and
Deakin University

Maria Northcote
Avondale University

Hannah Rosebrock
Avondale University

Why was the study needed?

Approximately 26% of patients admitted to a hospital will receive an indwelling urinary catheter. Of those, 1% will also develop a catheter associated urinary tract infection (CAUTI)1. Healthcare associated urinary traction infections are associated with higher hospital costs and increase the length of hospital stay.2 Prolonged and unnecessary catheterisation appears to be the main risk factor for development of CAUTI’s.1, 3


Results will have just been published, here is a link to the article: :

Download Video File


Concluding remarks will be posted here upon study completion (end of 2018).

Resources, further information and dissemination of results

Publication protocol: Click here

For those on Twitter, updates are provided by @1healthau or follow #cautiaus or contact [email protected]

Hannah Rosebrock, project officer, presenting the CATH TAG project pre-results at the Australasian Conference of Infection Prevention and Control in Canberra 2017


  1. Gardner A, Mitchell B, Beckingham W, Fasugba O. A point prevalence cross-sectional study of healthcare-associated urinary tract infections in six Australian hospitals. BMJ Open 2014;4
  2. Mitchell BG, Ferguson JK, Anderson M, Sear J, Barnett A. Length of stay and mortality associated with healthcare-associated urinary tract infections: a multi-state model. J. Hosp. Inf
  3. Jain P, Parada JP, David A, et al. Overuse of the indwelling urinary tract catheter in hospitalized medical patients. Arch Intern Med 1995;155(13):1425-9. [published Online First: 1995/07/10]
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