A multifaceted quality improvement strategy reduces the risk of catheter-associated urinary tract infection
| Autor: | Robert S. Dittus, Cecelia Theobald, Matthew J Resnick, Christianne L. Roumie, Thomas Spain |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Quality management Hospitals Veterans Population 030501 epidemiology Clinical decision support system 03 medical and health sciences 0302 clinical medicine Catheters Indwelling Hospital-acquired infection medicine Infection control Humans 030212 general & internal medicine education Intensive care medicine Catheter-associated urinary tract infection Veterans education.field_of_study business.industry Health Policy Public Health Environmental and Occupational Health General Medicine medicine.disease Decision Support Systems Clinical Quality Improvement Tennessee Discontinuation Catheter Catheter-Related Infections Urinary Tract Infections Accidental Falls 0305 other medical science business |
| Zdroj: | International journal for quality in health care : journal of the International Society for Quality in Health Care. 29(4) |
| ISSN: | 1464-3677 |
| Popis: | Objective Catheter-associated urinary tract infections (CAUTIs) are common and preventable hospital-acquired infections, yet their rate continues to rise nationwide. We describe the implementation of a multifaceted program to reduce catheter use and CAUTI rates while simultaneously addressing barriers to long-term success. Design/setting/participants Pre-post study of medical inpatient veterans between December 2012 and February 2015. Intervention Five component intervention: (i) a bedside catheter reminder; (ii) multidisciplinary educational campaign; (iii) structured catheter order set with clinical decision support; (iv) automated catheter discontinuation orders; and (v) protocol for post-catheter removal care. Main outcome measure(s) Catheter utilization rates and CAUTI rates on the study ward were followed during the 14-week baseline period, the 27-week transition/intervention period and the 70-week period of full implementation/sustainability. Rates of patient falls per bed days and catheter reinsertions were collected during the same time periods as balancing measures. Results Catheter use declined by 35% from the baseline period to the full implementation/sustainability period. This improvement was not realized until deployment of the structured electronic orders with automated catheter discontinuation and protocolized post-catheter care. The average number of days between CAUTIs on the study ward increased from 101 days in the baseline period to over 400 days in the full implementation/sustainability period. There was no significant change in the rates of falls or catheter reinsertions during the study period. Conclusions A multicomponent intervention aimed specifically at targeting local barriers was successful in reducing catheter utilization as well as CAUTIs in a veteran population without compensatory increase in patient falls or catheter replacement. |
| Databáze: | OpenAIRE |
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