Economic evaluation of quality improvement interventions to prevent catheter-associated urinary tract infections in the hospital setting: a systematic review

2021 ◽  
pp. bmjqs-2021-013839
Author(s):  
Sara G McCleskey ◽  
Lili Shek ◽  
Jonathan Grein ◽  
Hiroshi Gotanda ◽  
Laura Anderson ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Urinary Tract ◽  
Acute Care ◽  
Urinary Tract Infections ◽  
Grey Literature ◽  
Hospital Setting ◽  
Cost Savings ◽  
Acute Care Hospitals ◽  
Economic Evaluations ◽  
Tract Infections

BackgroundHospitals have implemented diverse quality improvement (QI) interventions to reduce rates of catheter-associated urinary tract infections (CAUTIs). The economic value of these QI interventions is uncertain.ObjectiveTo systematically review economic evaluations of QI interventions designed to prevent CAUTI in acute care hospitals.MethodsA search of Ovid MEDLINE, Econlit, Centre for Reviews & Dissemination, New York Academy of Medicine’s Grey Literature Report, WorldCat, IDWeek conference abstracts and prior systematic reviews was conducted from January 2000 to October 2020.We included English-language studies of any design that evaluated organisational or structural changes to prevent CAUTI in acute care hospitals, and reported programme and infection-related costs.Dual reviewers assessed study design, effectiveness, costs and study quality. For each eligible study, we performed a cost-consequences analysis from the hospital perspective, estimating the incidence rate ratio (IRR) and incremental net cost/savings per hospital over 3 years. Unadjusted weighted regression analyses tested predictors of these measures, weighted by catheter days per study.ResultsFifteen unique economic evaluations were eligible, encompassing 74 hospitals. Across 12 studies amenable to standardisation, QI interventions were associated with a 43% decline in infections (mean IRR 0.57, 95% CI 0.44 to 0.70) and wide ranges of net costs (mean US$52 000, 95% CI −$288 000 to $392 000), relative to usual care.ConclusionsQI interventions were associated with large declines in infection rates and net costs to hospitals that varied greatly but that, on average, were not significantly different from zero over 3 years. Future research should examine specific practices associated with cost-savings and clinical effectiveness, and examine whether or not more comprehensive interventions offer hospitals and patients the best value.

Strategies to Prevent Catheter-Associated Urinary Tract Infections in Acute Care Hospitals: 2014 Update

2014 ◽  
Vol 35 (5) ◽  
pp. 464-479 ◽  
Author(s):  
Evelyn Lo ◽  
Lindsay E. Nicolle ◽  
Susan E. Coffin ◽  
Carolyn Gould ◽  
Lisa L. Maragakis ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Acute Care ◽  
Urinary Tract Infections ◽  
Acute Care Hospitals ◽  
Guidance Document ◽  
American Hospital ◽  
American Hospital Association ◽  
Tract Infections ◽  
Healthcare Associated ◽  
Healthcare Epidemiology

Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections (HAIs). The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their catheter-associated urinary tract infection (CAUTI) prevention efforts. This document updates “Strategies to Prevent Catheter-Associated Urinary Tract Infections in Acute Care Hospitals,” published in 2008. This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA) and is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA). the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise. The list of endorsing and supporting organizations is presented in the introduction to the 2014 updates.

scholarly journals Strategies to Prevent Catheter-Associated Urinary Tract Infections in Acute Care Hospitals: 2014 Update

2014 ◽  
Vol 35 (S2) ◽  
pp. S32-S47 ◽  
Author(s):  
Evelyn Lo ◽  
Lindsay E. Nicolle ◽  
Susan E. Coffin ◽  
Carolyn Gould ◽  
Lisa L. Maragakis ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Acute Care ◽  
Urinary Tract Infections ◽  
Acute Care Hospitals ◽  
Guidance Document ◽  
American Hospital ◽  
American Hospital Association ◽  
Tract Infections ◽  
Healthcare Associated ◽  
Healthcare Epidemiology

Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections (HAIs). The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their catheter-associated urinary tract infection (CAUTI) prevention efforts. This document updates “Strategies to Prevent Catheter-Associated Urinary Tract Infections in Acute Care Hospitals,” published in 2008. This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA) and is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise. The list of endorsing and supporting organizations is presented in the introduction to the 2014 updates.

Strategies to Prevent Catheter-Associated Urinary Tract Infections in Acute Care Hospitals: 2014 Update

2014 ◽  
Vol 35 (S2) ◽  
pp. S32-S47 ◽  
Author(s):  
Evelyn Lo ◽  
Lindsay E. Nicolle ◽  
Susan E. Coffin ◽  
Carolyn Gould ◽  
Lisa L. Maragakis ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Acute Care ◽  
Urinary Tract Infections ◽  
Acute Care Hospitals ◽  
Guidance Document ◽  
American Hospital ◽  
American Hospital Association ◽  
Tract Infections ◽  
Healthcare Associated ◽  
Healthcare Epidemiology

Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections (HAIs). The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their catheter-associated urinary tract infection (CAUTI) prevention efforts. This document updates “Strategies to Prevent Catheter-Associated Urinary Tract Infections in Acute Care Hospitals,” published in 2008. This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA) and is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise. The list of endorsing and supporting organizations is presented in the introduction to the 2014 updates.

Reducing Catheter-Associated Urinary Tract Infections: A Quality-Improvement Initiative

PEDIATRICS ◽  
2014 ◽  
Vol 134 (3) ◽  
pp. e857-e864 ◽  
Author(s):  
K. F. Davis ◽  
A. M. Colebaugh ◽  
B. L. Eithun ◽  
S. B. Klieger ◽  
D. J. Meredith ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Quality Improvement Initiative ◽  
Tract Infections

scholarly journals 1162. An Evaluation of Metrics for Catheter-Associated Urinary Tract Infections (CAUTIs): A Statewide Comparison

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S415-S416
Author(s):  
Dana Pepe ◽  
Meghan Maloney ◽  
Vivian Leung ◽  
Adora Harizaj ◽  
David Banach ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Acute Care ◽  
Acute Care Hospitals ◽  
Healthcare Research ◽  
Hospital Data ◽  
Care Practices ◽  
Data Elements ◽  
Tract Infections ◽  
Facility Size ◽  
Catheter Care

Abstract Background The Standardized Infection Ratio (SIR) is a metric used to gauge catheter-associated urinary tract infection (CAUTI) prevention, both locally and nationally. The device utilization ratio (DUR) is a process metric that captures catheter harm. More recently, the cumulative attributable difference (CAD) was introduced, which identifies the number of excess infections that need to be prevented to reach the desired goal. Our objective was to evaluate these metrics across all acute care hospitals in Connecticut (CT) by facility size. Methods A CAUTI Targeted Assessment for Prevention (TAP) Report for acute care hospitals across CT was generated from 1/1/2018 to December 31/2018, using the National Healthcare Safety Network (NHSN) database. CAUTI events, SIR, DUR, and CAD were compared across all hospitals. The SIR goal of 0.75 was used to calculate the CAD. Hospitals were stratified into large ( >425 beds), medium (250 to 424 beds), and small ( <249 beds) based on the Healthcare Cost and Utilization Project NIS Description of Data Elements, Agency for Healthcare Research and Quality for urban hospitals in the northeast region. Results A comparison of CAUTI metrics for 29 acute care hospitals across CT is shown in Table 1. Median SIR and DUR were 0.97, 1.02, 0.77, and 22%, 14%, 14.5% for large, medium and small hospitals, respectively. Of the 20 small hospitals, SIR could not be calculated for 5 hospitals, while 2 hospitals had an SIR = 0, as they had no reported infections. Median CAD for large, medium and small hospitals was 6.17, 1.3 and 0.25, respectively. Of note, 40% of small hospitals (J – CC, as in Table 1) had a negative CAD. Interestingly, 5 of these 8 hospitals with a negative CAD had a DUR higher than 16%. Conclusion Based on CT hospital data, metrics like CAD and SIR may be more suitable for larger hospitals or hospitals with higher CAUTI events, whereas DUR may be a more useful metric for smaller hospitals or hospitals with rare events. Hospitals with high SIR and low DUR may represent a population with high-risk catheter use, poor catheter care or higher rates of urine culturing. On the other hand, hospitals with high DUR and low SIR may represent low-risk populations, better catheter care practices or lower rates of urine culturing. Ultimately, we need a combination of metrics to measure preventable catheter harm. Disclosures Louise Dembry, MD, MS, MBA, ReadyDock: Consultant, Stock options.

A Retrospective Study on Urinary Tract Infections in a In-patient Rehabilitation Hospital Setting

2014 ◽  
Vol 42 (6) ◽  
pp. S118-S119
Author(s):  
Asif Saiyed ◽  
Alan Anschel ◽  
Eileen French ◽  
Mary Kuncis ◽  
James Purdy ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Hospital Setting ◽  
Rehabilitation Hospital ◽  
Tract Infections

scholarly journals An introduction to the epidemiology and burden of urinary tract infections

2019 ◽  
Vol 11 ◽  
pp. 175628721983217 ◽  
Author(s):  
Martha Medina ◽  
Edgardo Castillo-Pino
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Relevant Literature ◽  
Hospital Setting ◽  
The United States ◽  
Adult Women ◽  
Local Data ◽  
Female Population ◽  
Physician Visits ◽  
Tract Infections

Urinary tract infections (UTIs) are the most common outpatient infections, with a lifetime incidence of 50−60% in adult women. This is a narrative review aimed at acting as an introduction to the epidemiology and burden of UTIs. This review is based on relevant literature according to the experience and expertise of the authors. The prevalence of UTI increases with age, and in women aged over 65 is approximately double the rate seen in the female population overall. Etiology in this age group varies by health status with factors such as catheterization affecting the likelihood of infection and the pathogens most likely to be responsible. In younger women, increased sexual activity is a major risk factor for UTIs and recurrence within 6 months is common. In the female population overall, more serious infections such as pyelonephritis are less frequent but are associated with a significant burden of care due to the risk of hospitalization. Healthcare-associated UTIs (HAUTIs) are the most common form of healthcare-acquired infection. Large global surveys indicate that the nature of pathogens varies between the community and hospital setting. In addition, the pathogens responsible for HAUTIs vary according to region making adequate local data key to infection control. UTIs create a significant societal and personal burden, with a substantial number of medical visits in the United States every year being related to UTIs. European data indicate that recurrent infections are related to increased absenteeism and physician visits. In addition, quality of life measures are significantly impacted in women suffering from recurrent UTIs. Data suggest that nonantimicrobial prophylactic strategies offer an opportunity to reduce both the rate of UTIs and the personal burden experience by patients.

scholarly journals Rapid review of hand hygiene efficacy in reduction catheter associated urinary tract infections

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Muath Elwaisi ◽  
Mahmoud Al-Masaeed ◽  
Rawan Alsababha ◽  
Muhammad Alqudah
Keyword(s):  
Health Care ◽  
Urinary Tract ◽  
Hand Hygiene ◽  
Acute Care ◽  
Urinary Tract Infections ◽  
Experimental Studies ◽  
Rapid Review ◽  
Care Workers ◽  
Prevention Of Infections ◽  
Tract Infections

Background: This review has been undertaken to evaluate the effectiveness of the hand hygiene in the prevention of catheter associated urinary tract infections among patients admitted in the acute care settings. Catheter associated infections are totally preventable and the morbidity and mortality associated with these infections cause a burden on the healthcare system and the economy of the country. Hand hygiene of the health care personnel’s is the most effective and economical way in the prevention of infections associated with the urinary catheters. Objective: This review to find out the effectiveness of hand hygiene for the prevention or reduction in the rate of catheter associated urinary tract infections among patients admitted in the acute care setting. Result: Five different experimental studies identified the effectiveness of hand hygiene of healthcare workers on the rates of catheter associated urinary tract infections. Conclusion: Hand hygiene is effective in the prevention of catheter associated urinary tract infections when health care workers perform it as per the five moments of hand hygiene given by WHO.

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