A Program to Prevent Catheter-Associated Urinary Tract Infection in Acute Care.

Area of Science:

• Healthcare-associated infections
• Patient safety initiatives
• Infection prevention and control

Background:

• Catheter-associated urinary tract infection (UTI) is a prevalent hospital-acquired infection.
• Prevention requires attention to both technical aspects of catheter use and socio-behavioral factors within hospital units.

Purpose of the Study:

• To evaluate the impact of a national prevention program on catheter-associated UTI rates and catheter use in intensive care units (ICUs) and non-ICUs.
• To assess the effectiveness of a program emphasizing technical and socio-behavioral strategies for UTI prevention.

Main Methods:

• The Comprehensive Unit-based Safety Program disseminated information and guidance on UTI prevention strategies.
• Data on catheter use and catheter-associated UTI rates were collected across 926 units in 603 hospitals.
• Multilevel negative binomial models analyzed changes in rates during baseline, implementation, and sustainability phases.

Main Results:

• Overall catheter-associated UTI rates decreased from 2.82 to 2.19 per 1000 catheter-days (unadjusted) and 2.40 to 2.05 (adjusted).
• In non-ICUs, catheter use decreased by 7.3% and catheter-associated UTI rates fell by 32.5%.
• Significant reductions were observed in non-ICUs, while rates remained largely unchanged in ICUs, indicating differential program effectiveness.

Conclusions:

• A national prevention program successfully reduced catheter use and catheter-associated UTI rates, particularly in non-ICU settings.
• The findings support the integration of technical and socio-behavioral interventions for effective UTI prevention in hospitals.