Urinary Catheters Associated with HAIs
The January issue of Clinical Infectious Diseases includes a report describing means to reduce the incidence of catheter infections, based on an evaluation of almost 720 hospitals. The study notes that forty percent of hospital infections are urinary tract infections arising from catheters.
The research team included patient safety specialists from the VA Ann Arbor System and the University of Michigan. The assessment entailed review of catheter procedures at 719 hospitals in the U.S. with over 50 beds. 119 of the facilities are part of the Veterans Affairs System. This was the first national study of its kind.
Data was collected by submitting questionnaires to infection control specialists at the facilities. The response rate was 72 percent. The team noted that over thirty percent of hospitals do not monitor ongoing use of catheters in their patients. Almost seventy-five percent of the facilities did track the length of time that patients had their catheters.
Thirty percent of the hospitals utilized portable bladder scanners and antimicrobial urinary catheters, 14 percent employed condom catheters, and nine percent employed a catheter reminder system. The VA Hospitals were more likely to utilize portable bladder scanners, as well as condom catheters and suprapubic catheters. Non-VA facilities were more likely to use antimicrobial catheters.
The time-tested method to monitor catheter use is with reminders. Data collected indicated that less than ten percent of clinicians utilized this tool to assess catheters status and remind them to remove such.
The study team from the University of Michigan notes that mnany hospitals do not have strategies in place to reduce the incidence of urinary tract infections. Systems must be adopted to remind clinicians about catheter maintenance. Another method to reduce the incidence of infection is adoption of antimicrobial catheters, which would only cost $5 per patient.
Catheters are frequently used in patients after undergoing surgery. Overall data indicates that twenty-five percent of patients in the acute care setting have catheters in place. Data gleaned from this analysis points out that some of these catheters are medically unnecessary. Moreover, catheter use in one third of patients may extend past the point of necessity.
This study is receiving attention because of the Medicare regulations beginning this fall that will discontinue reimbursement for certain hospital-acquired or never events, one of which is urinary tract infections. Estimates of Medicare costs associated with one urinary tract infection is over $40,000. This change in reimbursement policies was previously described on HospitalBuyer. In addition, more and more facilities are adopting a policy of not charging patients or payors for never events.
January 14, 2008 Related topics: Trends, Quality, Safety, Errors, Surgery, Renal & Urology