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Preventing Catheter-Associated Urinary Tract Infection in the United States: A National Comparative Study.
JAMA Intern Med. 2013 Mar 25;:1-6
Authors: Saint S, Greene MT, Kowalski CP, Watson SR, Hofer TP, Krein SL
Abstract
IMPORTANCE Despite the national goal to reduce catheter-associated urinary tract infection (CAUTI) by 25% by 2013, limited data exist describing prevention practices for CAUTI in US hospitals and none associate national practice use to CAUTI-specific standardized infection ratios (SIRs). OBJECTIVES To identify practices currently used to prevent CAUTI and to compare use and SIRs for a national sample of US hospitals with hospitals in the state of Michigan, which launched a CAUTI prevention initiative in 2007 ("Keystone Bladder Bundle Initiative"). DESIGN AND SETTING In 2009, we surveyed infection preventionists at a sample of US hospitals and all Michigan hospitals. CAUTI rate differences between Michigan and non-Michigan hospitals were assessed using SIRs. PARTICIPANTS A total of 470 infection preventionists. MAIN OUTCOME MEASURES Reported regular use of CAUTI prevention practices and CAUTI-specific SIR data. RESULTS Michigan hospitals, compared with hospitals in the rest of the United States, more frequently participated in collaboratives to reduce health care-associated infection (94% vs 67%, P < .001) and used bladder scanners (53% vs 39%, P = .04), as well as catheter reminders or stop orders and/or nurse-initiated discontinuation (44% vs 23%, P < .001). More frequent use of preventive practices coincided with a 25% reduction in CAUTI rates in the state of Michigan, a significantly greater reduction than the 6% overall decrease observed in the rest of the United States. CONCLUSIONS AND RELEVANCE We observed more frequent use of key prevention practices and a lower rate of CAUTI in Michigan hospitals relative to non-Michigan hospitals. This may be related to Michigan's significantly higher use of practices aimed at timely removal of urinary catheters, the key focus area of Michigan's Keystone Bladder Bundle Initiative.
PMID: 23529579 [PubMed - as supplied by publisher]