Abstract
Background
Urinary tract infections (UTIs) continue to be one of the most common types of healthcare-associated infections (HAIs). Instrumentation of the urinary tract using devices such as indwelling urinary catheters (IUCs) is the leading cause of healthcare-associated UTIs. Every day that a patient has an IUC increases their risk of acquiring a UTI. After an increase in the number of catheter-associated urinary tract infections (CAUTIs), a mid-sized acute care hospital in the Northeast United States used an electronic surveillance system to monitor IUC order compliance and appropriateness in order to reduce IUC utilization and prevent CAUTIs.
Methods
Using an Infection Prevention (IP) electronic surveillance system, a line list was generated of patients who had an IUC documented in the urinary flow sheet of their electronic medical record. This list contained variables such as: catheter insert date, catheter order status, and catheter indication. IP staff sent this list in a daily e-mail to clinical leadership and front line staff over a 14 month period. The e-mail notified providers when their patients had an IUC without an order. Clinical staff was directed to discontinue the IUC if it was no longer indicated or to place a new IUC order if still indicated. The National Healthcare Safety Network (NHSN) CAUTI definition and data functions were used for the purposes of this study.
Results
A statistically significant (P = 0.017) reduction in the hospital CAUTI rate was found when a comparison was made between the 14-month pre-intervention baseline period (1.12 CAUTI per 1,000 catheter days) and the 14 month post-intervention period (0.29 CAUTI per 1,000 catheter days). A statistically significant decrease (P = 0.0004) in IUC utilization was also noted for the same time period, decreasing from 8.2 catheters per 100 patient-days to 7.8 catheters per 100 patient-days.
Conclusion
A significant reduction in CAUTIs and IUC utilization was seen over the 14-month IP-driven e-mail intervention. This study suggests that regular electronic communication of surveillance system information to providers may reduce CAUTIs.
Disclosures
All authors: No reported disclosures.
The prevention of healthcare associated urinary tract infections from the point of view of nursing care
