i
A Program to Prevent Catheter-Associated Urinary Tract Infection in Acute Care
-
6 02 2016
-
-
Source: N Engl J Med. 374(22):2111-2119
[PDF-216.51 KB]
Details:
-
Alternative Title:N Engl J Med
-
Personal Author:
-
Description:BACKGROUND
Catheter-associated urinary tract infection (UTI) is a common device-associated infection in hospitals. Both technical factors — appropriate catheter use, aseptic insertion, and proper maintenance — and socioadaptive factors, such as cultural and behavioral changes in hospital units, are important in preventing catheter-associated UTI.
METHODS
The national Comprehensive Unit-based Safety Program, funded by the Agency for Healthcare Research and Quality, aimed to reduce catheter-associated UTI in intensive care units (ICUs) and non-ICUs. The main program features were dissemination of information to sponsor organizations and hospitals, data collection, and guidance on key technical and socioadaptive factors in the prevention of catheter-associated UTI. Data on catheter use and catheter-associated UTI rates were collected during three phases: baseline (3 months), implementation (2 months), and sustainability (12 months). Multilevel negative binomial models were used to assess changes in catheter use and catheter-associated UTI rates.
RESULTS
Data were obtained from 926 units (59.7% were non-ICUs, and 40.3% were ICUs) in 603 hospitals in 32 states, the District of Columbia, and Puerto Rico. The unadjusted catheter-associated UTI rate decreased overall from 2.82 to 2.19 infections per 1000 catheter-days. In an adjusted analysis, catheter-associated UTI rates decreased from 2.40 to 2.05 infections per 1000 catheter-days (incidence rate ratio, 0.86; 95% confidence interval [CI], 0.76 to 0.96; P = 0.009). Among non-ICUs, catheter use decreased from 20.1% to 18.8% (incidence rate ratio, 0.93; 95% CI, 0.90 to 0.96; P<0.001) and catheter-associated UTI rates decreased from 2.28 to 1.54 infections per 1000 catheter-days (incidence rate ratio, 0.68; 95% CI, 0.56 to 0.82; P<0.001). Catheter use and catheter-associated UTI rates were largely unchanged in ICUs. Tests for heterogeneity (ICU vs. non-ICU) were significant for catheter use (P = 0.004) and catheter-associated UTI rates (P = 0.001).
CONCLUSIONS
A national prevention program appears to reduce catheter use and catheter-associated UTI rates in non-ICUs. (Funded by the Agency for Healthcare Research and Quality.)
-
Subjects:
-
Source:
-
Pubmed ID:27248619
-
Pubmed Central ID:PMC9661888
-
Document Type:
-
Funding:
-
Collection(s):
-
Main Document Checksum:
-
Download URL:
-
File Type:
