Postoperative Urinary Tract Infection Quality Assessment and Improvement: The S.T.O.P. UTI Program and Its Impact on...

Area of Science:

• Healthcare Quality Improvement
• Infectious Disease Prevention
• Surgical Patient Care

Background:

• Postoperative urinary tract infections (UTIs) are a common complication, negatively impacting patient experience and increasing healthcare costs.
• Developing effective assessment tools is crucial for implementing targeted quality improvement initiatives to reduce UTI incidence.

Purpose of the Study:

• To develop a urinary tract care assessment tool to guide actionable quality improvement initiatives.
• To systematically evaluate and improve elements of urinary catheter care in surgical patients.

Main Methods:

• The S.T.O.P. UTI algorithm was developed by multidisciplinary teams to assess sterile placement, timely removal, optimal bag position, and proper urine sampling.
• Targeted interventions were implemented based on assessment findings, including provider education and process adjustments.
• Urinary tract infection rates were monitored pre- and post-intervention.

Main Results:

• The assessment identified opportunities for improvement in catheter removal timing, bag positioning, and urine sampling procedures.
• Following interventions, non-risk-adjusted UTI rates in surgical patients decreased significantly from 2.90% to 0.46% (p = 0.0003).
• Hospital-wide catheter-associated UTI rates also declined substantially, from 2.24/1,000 catheter-days to 0.70/1,000 catheter-days (p < 0.001).

Conclusions:

• The S.T.O.P. UTI algorithm provides a systematic method for hospitals to assess and improve urinary tract infection prevention processes.
• This tool can identify institutional-specific areas for improvement, optimizing resource allocation for quality initiatives.
• Implementing the S.T.O.P. UTI algorithm effectively reduces both surgical and medical UTIs.