Thursday, October 10

Infection Prevention Model Has Potential to Lower Rates of Catheter Associated UTIs

Enforcing prevention efforts to minimize the chances of hospital-borne infections has shown to have a big impact on the rate of bloodstream infections. At short-term acute care hospitals where these prevention methods were highlighted and highly enforced, the number of central-line bloodstream infections was reduced by 50% in 2014, compared to the numbers in 2008.

These methods are nothing radical. Instead, they have been known to be as simple as a reminder checklist for hospital staff. These checklists serve as reminders for clinicians to wash their hands, to clean the skin of a patient, or to change soiled dressings. Although it’s assumed that hospital staff will wash hands thoroughly and clean surfaces, many facilities fall short of the goal. Keeping a level of high expectations is paramount to success.

Although not all hospitals were 100% successful in keeping these infections at bay, there was definitively marked improvement. Now experts are speculating that implementing similar efforts towards catheter-associated urinary tract infections could finally have an effect on the rate of infection.

Catheter-associated urinary tract infections, or CAUTI’s, are the most common type of healthcare-associated infections. Of all the types of healthcare-associated infections, they account for more than 30%. What’s more, virtually all of healthcare-associated urinary tract infections are caused by instrumentation of the urinary tract — in other words, the insertion of catheters.
Furthermore, the rates of CAUTI’s have not changed in recent years. These infections often occur in hospitals and can extend stays, require antibiotics, and even lead to an approximate 13,000 deaths every year.

The use of urinary catheters continues to grow. Experts implore that new action must be taken in order to prevent these potentially dangerous infections. Overall, the consensus is that catheters need to be used less often, or for a shorter length of time.

According to Dr. Marvin Moe Bell of HonorHealth Scottsdale in Arizona, definitive measures can be taken in order to reduce the rate of CAUTIs. The intensive care unit at Dr. Bell’s hospital, the Scottsdale Osborne Medical Center, had a particularly high rate of catheter-associated UTIs — about 60% higher than the expected rate. By implementing an educational system for clinicians, Dr. Bell and his team saw a significant decrease in the amount of CAUTI’s in their hospital.

The system dispenses information about when catheters are or aren’t recommended, asks for justification from the clinician when a catheter is ordered and gives a daily reminder of the patient’s health record to prompt clinicians to consider a catheter’s discontinuation. When the catheters weren’t used as often and for as long of a period of time, the infections decreased dramatically: in the ICU, infections dropped by 25% in 2014 and by 88% in 2015.

Combining cleanliness reminders with distinct educational methods has been shown to have a significant effect on the number of CAUTI’s sustained. However, these methods are not commonplace in many hospitals and healthcare centers, so medical professionals need to be diligent about enforcing and implementing these methods wherever they practice.

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