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Published on: July 13, 2019
Prevention of nosocomial catheter-associated urinary tract infections through computerized feedback to physicians and
Jeffrey Topal1, Sandra Conklin, Karen Camp
1Department of Pharmacy Services, Yale-New Haven Hospital, New Haven, Connecticut 06504, USA. jeffrey.topal@ynhh.org
Insights
Implementing technology and staff education significantly reduced catheter use and catheter-associated urinary tract infections (CAUTIs), a common hospital-acquired infection. This intervention led to an 81% decrease in device use and a 73% drop in CAUTI rates.
Area of Science:
- Healthcare-associated infections
- Infection control
- Urology
Background:
- Catheter-associated urinary tract infections (CAUTIs) are the most frequent nosocomial infections.
- Elevated baseline CAUTI rates (36 per 1000 catheter-days) and high rates of inappropriate indwelling urinary catheter use were observed.
Purpose of the Study:
- To decrease the incidence of CAUTIs.
- To reduce the use and duration of indwelling urinary catheterization.
Main Methods:
- Utilized computerized order entry prompts and handheld bladder scanners.
- Implemented staff education and nurse empowerment initiatives.
Main Results:
- Achieved an 81% reduction in urinary catheter device use.
- Demonstrated a 73% reduction in nosocomial CAUTI incidence (from 36 to 11 per 1000 catheter-days, P < .001).
Conclusions:
- A multifaceted approach combining technology, education, and empowerment effectively reduces CAUTI rates.
- Interventions targeting inappropriate catheter use are crucial for infection control in hospital settings.
Abstract:
Catheter-associated urinary tract infections (CAUTIs) represent the most common nosocomial infection. The authors' baseline rate of CAUTI for general medical service was elevated at 36 per 1000 catheter-days. The medical literature has consistently linked inappropriate catheter use with the development of CAUTI. The baseline data also revealed a high rate of inappropriate use of indwelling urinary catheters. Using the dual modalities of technology through prompts in the computerized order/entry system and handheld bladder scanners, as well as in combination with staff education and nurse empowerment, the authors were successful in reducing the use and duration of urinary catheters as well as the incidence of CAUTI. In subsequent data collection cycles over the following 2 years, 81% reduction in device use and a 73% reduction in the clinical end point of nosocomial CAUTI (36/1000 catheter-days to 11/1000 catheter-days; P < .001) was demonstrated.
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