scholarly journals Comparing Catheter-Associated Urinary Tract Infection Prevention Programs Between Veterans Affairs Nursing Homes and Non–Veterans Affairs Nursing Homes

2016 ◽  
Vol 38 (3) ◽  
pp. 287-293 ◽  
Author(s):  
Lona Mody ◽  
M. Todd Greene ◽  
Sanjay Saint ◽  
Jennifer Meddings ◽  
Barbara W. Trautner ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Nursing Homes ◽  
Tract Infection ◽  
System Integration ◽  
Infection Prevention ◽  
Prevention Programs ◽  
Veterans Affairs ◽  
Term Care ◽  
The Impact

OBJECTIVEThe impact of healthcare system integration on infection prevention programs is unknown. Using catheter-associated urinary tract infection (CAUTI) prevention as an example, we hypothesize that US Department of Veterans Affairs (VA) nursing homes have a more robust infection prevention infrastructure due to integration and centralization compared with non–VA nursing homes.SETTINGVA and non-VA nursing homes participating in the AHRQ Safety Program for Long-Term Care collaborative.METHODSNursing homes provided baseline information about their infection prevention programs to assess strengths and gaps related to CAUTI prevention via a needs assessment questionnaire.RESULTSA total of 353 of 494 nursing homes from 41 states (71%; 47 VA and 306 non-VA facilities) responded. VA nursing homes reported more hours per week devoted to infection prevention-related activities (31 vs 12 hours; P<.001) and were more likely to have committees that reviewed healthcare-associated infections. Compared with non-VA facilities, a higher percentage of VA nursing homes reported tracking CAUTI rates (94% vs 66%; P<.001), sharing CAUTI data with leadership (94% vs 70%; P=.014) and with nursing personnel (85% vs 56%, P=.003). However, fewer VA nursing homes reported having policies for appropriate catheter use (64% vs 81%; P=.004) and catheter insertion (83% vs 94%; P=.004).CONCLUSIONSAmong nursing homes participating in an AHRQ-funded collaborative, VA and non-VA nursing homes differed in their approach to CAUTI prevention. Best practices from both settings should be applied universally to create an optimal infection prevention program within emerging integrated healthcare systems.Infect Control Hosp Epidemiol 2017;38:287–293

scholarly journals 876Strategies for Success in Emergency Department Catheter-Associated Urinary Tract Infection Prevention Programs

2014 ◽  
Vol 1 (suppl_1) ◽  
pp. S251-S252
Author(s):  
Eileen J. Carter ◽  
Daniel J. Pallin ◽  
Leslie Mandel ◽  
Corine Sinnette ◽  
Jeremiah Schuur
Keyword(s):  
Emergency Department ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Infection Prevention ◽  
Prevention Programs

scholarly journals Infection Prevention and Antimicrobial Stewardship Knowledge for Selected Infections Among Nursing Home Personnel

2016 ◽  
Vol 38 (1) ◽  
pp. 83-88 ◽  
Author(s):  
Barbara W. Trautner ◽  
M. Todd Greene ◽  
Sarah L. Krein ◽  
Heidi L. Wald ◽  
Sanjay Saint ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Nursing Home ◽  
Urinary Tract ◽  
Nursing Homes ◽  
Tract Infection ◽  
Infection Prevention ◽  
Asymptomatic Bacteriuria ◽  
Healthcare Personnel ◽  
Healthcare Associated Infections ◽  
Healthcare Associated

OBJECTIVETo assess knowledge about infection prevention among nursing home personnel and identify gaps potentially addressable through a quality improvement collaborative.DESIGNBaseline knowledge assessment of catheter-associated urinary tract infection, asymptomatic bacteriuria, antimicrobial stewardship, and general infection prevention practices for healthcare-associated infections.SETTINGNursing homes across 14 states participating in the national “Agency for Healthcare Research and Quality Safety Program for Long-Term Care: Healthcare-Associated Infections/Catheter-Associated Urinary Tract Infection.”PARTICIPANTSLicensed (RNs, LPNs, APRNs, MDs) and unlicensed (clinical nursing assistants) healthcare personnel.METHODSEach facility aimed to obtain responses from at least 10 employees (5 licensed and 5 unlicensed). We assessed the percentage of correct responses.RESULTSA total of 184 (78%) of 236 participating facilities provided 1 response or more. Of the 1,626 respondents, 822 (50.6%) were licensed; 117 facilities (63.6%) were for-profit. While 99.1% of licensed personnel recognized the definition of asymptomatic bacteriuria, only 36.1% knew that pyuria could not distinguish a urinary tract infection from asymptomatic bacteriuria. Among unlicensed personnel, 99.6% knew to notify a nurse if a resident developed fever or confusion, but only 27.7% knew that cloudy, smelly urine should not routinely be cultured. Although 100% of respondents reported receiving training in hand hygiene, less than 30% knew how long to rub hands (28.5% licensed, 25.2% unlicensed) or the most effective agent to use (11.7% licensed, 10.6% unlicensed).CONCLUSIONSThis national assessment demonstrates an important need to enhance infection prevention knowledge among healthcare personnel working in nursing homes to improve resident safety and quality of care.Infect. Control Hosp. Epidemiol. 2016;1–6

scholarly journals Clinical outcomes of hospitalised patients with catheter-associated urinary tract infection in countries with a high rate of multidrug-resistance: the COMBACTE-MAGNET RESCUING study

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Aina Gomila ◽  
◽  
Jordi Carratalà ◽  
Noa Eliakim-Raz ◽  
Evelyn Shaw ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Antimicrobial Resistance ◽  
Tract Infection ◽  
Hospital Stay ◽  
Clinical Outcomes ◽  
Term Care ◽  
Hospitalised Patients ◽  
Increased Risk ◽  
The Impact

Abstract Background Although catheter-associated urinary tract infection (CA-UTI) is a major healthcare-related problem worldwide, there is a scarcity of current data from countries with high antimicrobial resistance rates. We aimed to determine the clinical outcomes of patients with CA-UTI compared to those of patients with other sources of complicated urinary tract infection (cUTI), and to assess the impact of antimicrobial resistance. We also aimed to identify the factors influencing 30-day mortality among patients with CA-UTI. Methods This was a multicentre, multinational retrospective cohort study including hospitalised adults with cUTI between January 2013 and December 2014 in twenty hospitals from eight countries from southern Europe, Turkey and Israel. The primary endpoint was 30-day mortality. The secondary endpoints were length of hospital stay, symptom improvement after 7 days’ treatment, symptom recurrence at 30 days and readmission 60 days after hospital discharge. Results Of the 807 cUTI episodes, 341 (42.2%) were CA-UTIs. The time from catheter insertion to cUTI diagnosis was less than 2 weeks in 44.6% of cases. Overall, 74.5% of cases had hospital or healthcare-acquired CA-UTI. Compared to patients with other cUTI aetiologies, those with CA-UTI had the following characteristics: they were more frequently males, older, admitted for a reason other than cUTI and admitted from a long-term care facility; had higher Charlson’s comorbidity index; and more frequently had polymicrobial infections and multidrug-resistant Gram-negative bacteria (MDR-GNB). Patients with CA-UTI also had significantly higher 30-day mortality rates (15.2% vs 6%) and longer hospital stay (median 14 [interquartile range -IQR- 7-27] days vs 8 [IQR 5–14] days) than patients with cUTI of other sources. After adjusting for confounders, CA-UTI was not independently associated with an increased risk of mortality (odds ratio, 1.40; 95% confidence interval, 0.77–2.54), and neither was the presence of MDR-GNB. Conclusions CA-UTI was the most frequent source of cUTI, affecting mainly frail patients. The mortality of patients with CA-UTI was high, though this was not directly related to the infection.

scholarly journals Economic Evaluation of a Catheter-Associated Urinary Tract Infection Prevention Program in Nursing Homes

2018 ◽  
Vol 66 (4) ◽  
pp. 742-747 ◽  
Author(s):  
David W. Hutton ◽  
Sarah L. Krein ◽  
Sanjay Saint ◽  
Nicholas Graves ◽  
Ajay Kolli ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Economic Evaluation ◽  
Urinary Tract ◽  
Nursing Homes ◽  
Tract Infection ◽  
Prevention Program ◽  
Infection Prevention
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