Urinary catheter-associated urinary tract infection for intensive care unit (ICU) patients (NQF 0138)

EMeasure Name Urinary catheter-associated urinary tract infection for intensive care unit (ICU) patients EMeasure Id 90DE3529-C9F6-4EC4-A6AA-359CDAB58A91
Version number 1 Set Id 3AC94B7E-38CB-4384-B449-B12B28140D80
Available Date No information Measurement Period January 1, 20xx through December 31, 20xx
Measure Steward Centers for Disease Control
Endorsed by National Quality Forum
Description Standardized Infection Ration (SIR) of healthcare-associated, catheter-associated urinary tract infections (CAUTI) among patients in intensive care units (ICUs), excluding patients in neonatal ICUs (NICUs).
Copyright
Measure scoring Ratio
Measure type Outcome
Stratification
None
Risk Adjustment
None
Data Aggregation
NQF-endorsed version: This measure is reported as a rate comprised of the number of catheter-associated urinary tract infections per 1,000 urinary catheter days for each hospital unit location included in scope for the measure.
            
Updated version undergoing endorsement evaluation: This measure is reported as a ratio of the observed rate of catheter-associated urinary tract infections per 1,000 urinary catheter days to the predicted rate of catheter-associated urinary tract Infections per 1,000 urinary catheter days calculated for each hospital unit location in scope for the measure and summarized across all locations.
         
Rationale
CAUTI is the most common type of healthcare-associated infection, accounting for more than 30% of acute care hospital infections. 
            There are 13,000 deaths associated with UTIs each year, an estimated 449,334 CAUTIs/yr, and a medical cost of $758/CAUTI. Total of >$340 million attributable to CAUTI in U.S. each year.
         
Clinical Recommendation Statement
Virtually all healthcare-associated urinary tract infections (UTIs) are caused by instrumentation of the urinary tract. CAUTI can lead to such complications as cystitis, pyelonephritis, gram-negative bacteremia, prostatitis, epididymitis, and orchitis in males, and, less commonly, endocarditis, vertebral osteomyelitis, septic arthritis, endophtalmitis, and meningitis in all patients.  Complications associated with CAUTI cause discomfort to the patient, prolonged hospital stay, and increased cost and mortality.
Improvement notation
It is envisioned that the use of this measure will promote CAUTI prevention activities which will lead to improved patient outcomes. Such activities include reducing the number of unnecessary indwelling catheters inserted, removing indwelling catheters at their earliest, clinically-appropriate time; avoiding patient exposures to antibiotics; reducing avoidable medical costs, and patient morbidity and mortality.
Measurement duration
12 month(s)
Reference
Klevens RM, Edwards JR, et al. Estimating healthcare-associated infection and deaths in U.S. hospitals, 2002. Public Health Reports 2007: 122:160-166.
Reference
Scott, RD. The Direct Medical Costs of Healthcare-Associated Infections in U.S. Hospitals and the Benefits of Prevention. http://www.cdc.gov/ncidod/dhqp/Scott_CostPaper.pdf assessed April 12, 2010.
Definition
Urinary tract infections (UTI) are defined using symptomatic urinary tract infection (SUTI) criteria or Asymptomatic Bacteremic UTI (ABUTI) criteria. 

indwelling catheter: a drainage tube that is inserted into the urinary bladder through the urethra, is left in place, and is connected to a closed collection system; also called a Foley catheter; does not include straight in-and-out catheters.
Guidance
For the determination of a symptomatic urinary tract infection, the signs or symptoms observed should not be attributed to another recognized cause.
            
For the asymptomatic bacteremic urinary tract infection (ABUTI) numerator criteria, the patient must have a positive urine culture of greater than or equal to 10,000 CFU/ml with no more than two species of uropathogen microorganisms AND a positive blood culture with at lease one matching uropathogen microorganism to the urine culture. The statement in the Numerator portion of the Population Criteria section, AND: "Laboratory test result: Blood culture for CAUTI" contains "Laboratory test result: Urine Culture (result value: 'uropathogens')" is intended to capture the positive blood culture with at least one matching uropathogen microorganism to the urine culture.

Table of Contents


Population criteria

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Measure Observation

Data criteria (QDS Data Elements)

Summary Calculation

Calculation is generic to all measures:



Measure set CLINICAL QUALITY MEASURE SET 2011-2012