A new national study reveals that hospitals can achieve significant reduction in both the rate of infection and the use of catheters.
Between 2011 and 2013—a time when hospital urinary tract infection (UTI) rates rose nationwide—603 hospitals participated in a customizable safety program involving 926 units. Those involved in the program saw an overall 14 percent reduction in the rate of CAUTI across all units and a 32 percent reduction in units outside of intensive care units (ICUs). The hospitals also reduced the overall use of catheters from 20.1 percent to 18.8 percent.
The hospitals participating in the 18-month program sponsored by the Agency for Healthcare Research and Quality provided physicians and nurses with a “Bladder Bundle” resource—a combination of protocols, checklists, and training modules—as well as data collection and analysis, to track progress.
"This program, in more than 10 percent of U.S. hospitals, shows we can make a difference in catheter-associated UTI rates and the use of catheters by addressing both technical and cultural aspects of healthcare," according to the lead author of the study published in The New England Journal of Medicine, Sanjay Saint, MD, MPH. Saint is a professor of internal medicine at the University of Michigan Medical School and chief of medicine at the VA Ann Arbor Healthcare System. “There's more work to be done, but all involved should take pride in knowing they helped move the needle on this important issue.”
About 12 percent of HAIs are urinary tract infections, and 80 percent of these UTIs are due to catheters. Each year, 250,000 CAUTIs occur in hospitals and cost about $250 million to treat. They are painful for patients and potentially dangerous, sometimes leading to sepsis and even death.
An NQF-endorsed National Healthcare Safety Network measure, #0138, helps hospitals track CAUTIs. NQF initially endorsed the Centers for Disease Control and Prevention (CDC) measure for ICUs in 2009. The CDC expanded the scope of the measure to include patient care areas outside of ICUs in acute care hospitals, as well as other facilities; NQF approved this broader measure in 2012.
While the program did not show significant reduction in either catheter use or CAUTIs among ICU patients, a recent initiative at NQF-member organization Mayo Clinic-Rochester has shown that CAUTIs can be reduced in the intensive care setting. Mayo Clinic-Rochester was awarded the 2015 John M. Eisenberg Patient Safety and Quality Award for a CAUTI program that reduced these infections to zero in a medical ICU and by about 70 percent hospital-wide. Learn more about Mayo’s program.