Multidisciplinary Project to Prevent Postoperative Urinary Tract Infection.

Area of Science:

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

Background:

• Postoperative urinary tract infections (UTIs) increase hospital stay, costs, and mortality.
• Analysis of American College of Surgeons (ACS) NSQIP data identified areas for practice improvement in urinary catheter management.
• Opportunities existed in catheter insertion, care, protocol adherence, and reporting.

Purpose of the Study:

• To reduce the incidence of postoperative UTIs through a multidisciplinary quality improvement program.
• To enhance adherence to best practices in urinary catheterization and UTI prevention protocols.
• To evaluate the effectiveness of implemented interventions on clinical processes and UTI rates.

Main Methods:

• A multidisciplinary team implemented interventions based on literature review and institutional data analysis.
• Interventions included staff education on UTI criteria and prevention, catheterization technique training, and performance feedback.
• Patient education kits and videos were developed for those discharged with catheters.

Main Results:

• Compliance improved for hand hygiene (62% to 83%), periurethral cleansing (66% to 97%), and catheter positioning (41% to 93%).
• Surgery residents' UTI knowledge scores increased from 71% to 81%.
• The unadjusted rate of postoperative UTIs decreased from 1.55% to 0.69% (p=0.016).

Conclusions:

• A comprehensive quality improvement program involving provider training and patient education effectively reduced postoperative UTIs.
• Interventions led to significant improvements in clinical practices related to urinary catheter use.
• The study demonstrates a successful strategy for decreasing healthcare-associated infections in surgical patients.