Related Experiment Video
Updated: Jan 18, 2026
An In Vitro Bladder Model of Catheter-Associated Urinary Tract Infection
Published on: June 24, 2025
Quantitative Results of a National Intervention to Prevent Hospital-Acquired Catheter-Associated Urinary Tract
Jennifer Meddings1, Milisa Manojlovich2, Jessica M Ameling3
1University of Michigan Medical School and Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan (J.M., M.T.G., S.S.).
Insights
A multimodal initiative did not significantly reduce catheter-associated urinary tract infections (CAUTI) in hospitals. The study found minimal changes in CAUTI rates and catheter use, suggesting limited effectiveness of the intervention.
Area of Science:
- Infection Prevention and Control
- Public Health
- Healthcare Quality Improvement
Background:
- Hospitals face challenges in preventing catheter-associated urinary tract infections (CAUTI).
- Healthcare-associated infections (HAI) pose a significant burden on healthcare systems.
Purpose of the Study:
- To assess the impact of a multimodal initiative on CAUTI rates in hospitals with a high prevalence of HAIs.
- To evaluate changes in urinary catheter device utilization.
Main Methods:
- A prospective, national, nonrandomized, pre-post observational quality improvement initiative was conducted.
- The intervention involved a Practice Change Assessment tool, web-based modules, webinars, and in-person meetings.
- Data on CAUTI rates and catheter utilization were collected from 361 hospitals over 3 cohorts.
Main Results:
- The unadjusted CAUTI rate showed a slight decrease from 1.12 to 1.04 per 1000 catheter-days.
- Urinary catheter utilization decreased from 21.46 to 19.83 per 100 patient-days.
- No substantial improvements in CAUTI rates or catheter utilization were observed.
Conclusions:
- The implemented multimodal intervention did not lead to significant reductions in CAUTI.
- Limitations include a brief intervention period, lack of fidelity assessment, and low baseline CAUTI rates.
Background:
Many hospitals struggle to prevent catheter-associated urinary tract infection (CAUTI).
Objective:
To evaluate the effect of a multimodal initiative on CAUTI in hospitals with high burden of health care-associated infection (HAI).
Design:
Prospective, national, nonrandomized, clustered, externally facilitated, pre-post observational quality improvement initiative, for 3 cohorts active between November 2016 and May 2018.
Setting:
Acute care, long-term acute care, and critical access hospitals, including intensive care and non-intensive care wards.
Participants:
Target hospitals had a high burden of Clostridioides difficile infection plus central line-associated bloodstream infection, CAUTI, or hospital-onset methicillin-resistant Staphylococcus aureus bloodstream infection, defined as cumulative attributable differences above the first tertile in the Targeted Assessment for Prevention (TAP) strategy. Some additional nonrecruited hospitals also joined.
Intervention:
Multimodal intervention, including Practice Change Assessment tool to identify infection prevention and control (IPC) and HAI prevention gaps; Web-based, on-demand modules involving onboarding, foundational IPC practices, HAI-specific 2-tiered approach to prioritize and implement interventions, and TAP resources; monthly webinars; state partner-led in-person meetings; and feedback. State partners made site visits to at least 50% of their enrolled hospitals, to support self-assessments and coach.
Measurements:
Rates of CAUTI and urinary catheter device utilization ratio.
Results:
Of 387 participating hospitals from 23 states and the District of Columbia, 361 provided CAUTI data. Over the study period, the unadjusted CAUTI rate was low and relatively stable, decreasing slightly from 1.12 to 1.04 CAUTIs per 1000 catheter-days. Catheter utilization decreased from 21.46 to 19.83 catheter-days per 100 patient-days from the pre- to the postintervention period.
Limitations:
The intervention period was brief, with no assessment of fidelity. Baseline CAUTI rates were low. Patient characteristics were not assessed.
Conclusion:
This multimodal intervention yielded no substantial improvements in CAUTI or urinary catheter utilization.
Primary Funding Source:
Centers for Disease Control and Prevention.
Related Concept Videos
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
01:26Urine Studies II: Urine Culture and Sensitivity Test
01:17Urinary Tract Infection IV: Nursing Management
01:25Urinary Tract Infection II: Pathophysiology