Preventing Hospital-Acquired Urinary Tract Infection in the United States: A National Study
Background. Although urinary tract infection (UTI) is the most common hospital-acquired infection in the United States, to our knowledge, no national data exist describing what hospitals in the United States are doing to prevent this patient safety problem. We conducted a national study to examine t...
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Veröffentlicht in: | Clinical infectious diseases 2008-01, Vol.46 (2), p.243-250 |
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creator | Saint, Sanjay Kowalski, Christine P. Kaufman, Samuel R. Hofer, Timothy P. Kauffman, Carol A. Olmsted, Russell N. Forman, Jane Banaszak-Holl, Jane Damschroder, Laura Krein, Sarah L. |
description | Background. Although urinary tract infection (UTI) is the most common hospital-acquired infection in the United States, to our knowledge, no national data exist describing what hospitals in the United States are doing to prevent this patient safety problem. We conducted a national study to examine the current practices used by hospitals to prevent hospital-acquired UTI. Methods. We mailed written surveys to infection control coordinators at a national random sample of nonfederal US hospitals with an intensive care unit and ⩾50 hospital beds (n=600) and to all Veterans Affairs (VA) hospitals (n=119). The survey asked about practices to prevent hospital-acquired UTI and other device-associated infections. Results. The response rate was 72%. Overall, 56% of hospitals did not have a system for monitoring which patients had urinary catheters placed, and 74% did not monitor catheter duration. Thirty percent of hospitals reported regularly using antimicrobial urinary catheters and portable bladder scanners; 14% used condom catheters, and 9% used catheter reminders. VA hospitals were more likely than non-VA hospitals to use portable bladder scanners (49% vs. 29%; P |
doi_str_mv | 10.1086/524662 |
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Although urinary tract infection (UTI) is the most common hospital-acquired infection in the United States, to our knowledge, no national data exist describing what hospitals in the United States are doing to prevent this patient safety problem. We conducted a national study to examine the current practices used by hospitals to prevent hospital-acquired UTI. Methods. We mailed written surveys to infection control coordinators at a national random sample of nonfederal US hospitals with an intensive care unit and ⩾50 hospital beds (n=600) and to all Veterans Affairs (VA) hospitals (n=119). The survey asked about practices to prevent hospital-acquired UTI and other device-associated infections. Results. The response rate was 72%. Overall, 56% of hospitals did not have a system for monitoring which patients had urinary catheters placed, and 74% did not monitor catheter duration. Thirty percent of hospitals reported regularly using antimicrobial urinary catheters and portable bladder scanners; 14% used condom catheters, and 9% used catheter reminders. VA hospitals were more likely than non-VA hospitals to use portable bladder scanners (49% vs. 29%; P<.001), condom catheters (46% vs. 12%; P<.001), and suprapubic catheters (22% vs. 9%; P<.001); non-VA hospitals were more likely to use antimicrobial urinary catheters (30% vs. 14%; P=.002). Conclusions. Despite the strong link between urinary catheters and subsequent UTI, we found no strategy that appeared to be widely used to prevent hospital-acquired UTI. The most commonly used practices—bladder ultrasound and antimicrobial catheters—were each used in fewer than one-third of hospitals, and urinary catheter reminders, which have proven benefits, were used in <10% of US hospitals.</description><identifier>ISSN: 1058-4838</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1086/524662</identifier><identifier>PMID: 18171256</identifier><identifier>CODEN: CIDIEL</identifier><language>eng</language><publisher>Chicago, IL: The University of Chicago Press</publisher><subject>Antimicrobials ; Articles and Commentaries ; Bacterial diseases ; Bacterial diseases of the urinary system ; Biological and medical sciences ; Catheterization ; Catheters ; Catheters, Indwelling - microbiology ; Condoms ; Cross Infection - microbiology ; Cross Infection - prevention & control ; General aspects ; Hospitals ; Human bacterial diseases ; Human infectious diseases. Experimental studies and models ; Humans ; Infection Control - methods ; Infections ; Infectious diseases ; Medical practice ; Medical sciences ; Nephrology. Urinary tract diseases ; Patient safety ; Ultrasonography ; United States ; Urinary bladder ; Urinary Bladder - diagnostic imaging ; Urinary Catheterization - adverse effects ; Urinary system involvement in other diseases. Miscellaneous ; Urinary tract diseases ; Urinary tract infections ; Urinary Tract Infections - microbiology ; Urinary Tract Infections - prevention & control ; Urinary tract. Prostate gland ; Urology</subject><ispartof>Clinical infectious diseases, 2008-01, Vol.46 (2), p.243-250</ispartof><rights>Copyright 2007 Infectious Diseases Society of America</rights><rights>2008 by the Infectious Diseases Society of America 2008</rights><rights>2008 INIST-CNRS</rights><rights>Copyright University of Chicago, acting through its Press Jan 15, 2008</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c483t-a392d896dd2369ccb34dc760b1e7589c325240599947063362ae707954d6ed4d3</citedby><cites>FETCH-LOGICAL-c483t-a392d896dd2369ccb34dc760b1e7589c325240599947063362ae707954d6ed4d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/40306882$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/40306882$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,776,780,799,27901,27902,57992,58225</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19984692$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18171256$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Saint, Sanjay</creatorcontrib><creatorcontrib>Kowalski, Christine P.</creatorcontrib><creatorcontrib>Kaufman, Samuel R.</creatorcontrib><creatorcontrib>Hofer, Timothy P.</creatorcontrib><creatorcontrib>Kauffman, Carol A.</creatorcontrib><creatorcontrib>Olmsted, Russell N.</creatorcontrib><creatorcontrib>Forman, Jane</creatorcontrib><creatorcontrib>Banaszak-Holl, Jane</creatorcontrib><creatorcontrib>Damschroder, Laura</creatorcontrib><creatorcontrib>Krein, Sarah L.</creatorcontrib><title>Preventing Hospital-Acquired Urinary Tract Infection in the United States: A National Study</title><title>Clinical infectious diseases</title><addtitle>Clinical Infectious Diseases</addtitle><addtitle>Clinical Infectious Diseases</addtitle><description>Background. Although urinary tract infection (UTI) is the most common hospital-acquired infection in the United States, to our knowledge, no national data exist describing what hospitals in the United States are doing to prevent this patient safety problem. We conducted a national study to examine the current practices used by hospitals to prevent hospital-acquired UTI. Methods. We mailed written surveys to infection control coordinators at a national random sample of nonfederal US hospitals with an intensive care unit and ⩾50 hospital beds (n=600) and to all Veterans Affairs (VA) hospitals (n=119). The survey asked about practices to prevent hospital-acquired UTI and other device-associated infections. Results. The response rate was 72%. Overall, 56% of hospitals did not have a system for monitoring which patients had urinary catheters placed, and 74% did not monitor catheter duration. Thirty percent of hospitals reported regularly using antimicrobial urinary catheters and portable bladder scanners; 14% used condom catheters, and 9% used catheter reminders. VA hospitals were more likely than non-VA hospitals to use portable bladder scanners (49% vs. 29%; P<.001), condom catheters (46% vs. 12%; P<.001), and suprapubic catheters (22% vs. 9%; P<.001); non-VA hospitals were more likely to use antimicrobial urinary catheters (30% vs. 14%; P=.002). Conclusions. Despite the strong link between urinary catheters and subsequent UTI, we found no strategy that appeared to be widely used to prevent hospital-acquired UTI. The most commonly used practices—bladder ultrasound and antimicrobial catheters—were each used in fewer than one-third of hospitals, and urinary catheter reminders, which have proven benefits, were used in <10% of US hospitals.</description><subject>Antimicrobials</subject><subject>Articles and Commentaries</subject><subject>Bacterial diseases</subject><subject>Bacterial diseases of the urinary system</subject><subject>Biological and medical sciences</subject><subject>Catheterization</subject><subject>Catheters</subject><subject>Catheters, Indwelling - microbiology</subject><subject>Condoms</subject><subject>Cross Infection - microbiology</subject><subject>Cross Infection - prevention & control</subject><subject>General aspects</subject><subject>Hospitals</subject><subject>Human bacterial diseases</subject><subject>Human infectious diseases. Experimental studies and models</subject><subject>Humans</subject><subject>Infection Control - methods</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Medical practice</subject><subject>Medical sciences</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Patient safety</subject><subject>Ultrasonography</subject><subject>United States</subject><subject>Urinary bladder</subject><subject>Urinary Bladder - diagnostic imaging</subject><subject>Urinary Catheterization - adverse effects</subject><subject>Urinary system involvement in other diseases. Miscellaneous</subject><subject>Urinary tract diseases</subject><subject>Urinary tract infections</subject><subject>Urinary Tract Infections - microbiology</subject><subject>Urinary Tract Infections - prevention & control</subject><subject>Urinary tract. Prostate gland</subject><subject>Urology</subject><issn>1058-4838</issn><issn>1537-6591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0V1rUzEYB_AgintRv4ESBb07mpy8e1eLWwdjyraC6EVIk1TTneZ0Sc5w396UU1YQxKuE_H958vIA8AKj9xhJ_oG1lPP2ETjEjIiGM4Uf1zlisqGSyANwlPMKIYwlYk_BAZZY4JbxQ_Dja_J3PpYQf8JZnzehmK6Z2NshJO_gPIVo0j28TsYWeBaX3pbQRxgiLL88nMdQqroqpvj8EU7ghdnGpqtLg7t_Bp4sTZf98914DOYnn6-ns-b8y-nZdHLe2Hq30hiiWicVd64lXFm7INRZwdECe8GksqStj0NMKUUF4oTw1niBhGLUce-oI8fg3Vh3k_rbweei1yFb33Um-n7IWiAsmKg7_wdbxAUVGFf45i-46odUH1YNVkogxfG-mk19zskv9SaFdf0ujZHeNkWPTanw1a7asFh7t2e7LlTwdgdMtqZbJhNtyHunlKRcbQu9Hl0_bP592MvRrHLp04OiiCAu5TZvxjzk4n8_5CbdaC6IYHr27bs-Of00vZCXl_qK_AFcM7N2</recordid><startdate>20080115</startdate><enddate>20080115</enddate><creator>Saint, Sanjay</creator><creator>Kowalski, Christine P.</creator><creator>Kaufman, Samuel R.</creator><creator>Hofer, Timothy P.</creator><creator>Kauffman, Carol A.</creator><creator>Olmsted, Russell N.</creator><creator>Forman, Jane</creator><creator>Banaszak-Holl, Jane</creator><creator>Damschroder, Laura</creator><creator>Krein, Sarah L.</creator><general>The University of Chicago Press</general><general>University of Chicago Press</general><general>Oxford University Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7T2</scope><scope>7T7</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20080115</creationdate><title>Preventing Hospital-Acquired Urinary Tract Infection in the United States: A National Study</title><author>Saint, Sanjay ; Kowalski, Christine P. ; Kaufman, Samuel R. ; Hofer, Timothy P. ; Kauffman, Carol A. ; Olmsted, Russell N. ; Forman, Jane ; Banaszak-Holl, Jane ; Damschroder, Laura ; Krein, Sarah L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c483t-a392d896dd2369ccb34dc760b1e7589c325240599947063362ae707954d6ed4d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Antimicrobials</topic><topic>Articles and Commentaries</topic><topic>Bacterial diseases</topic><topic>Bacterial diseases of the urinary system</topic><topic>Biological and medical sciences</topic><topic>Catheterization</topic><topic>Catheters</topic><topic>Catheters, Indwelling - microbiology</topic><topic>Condoms</topic><topic>Cross Infection - microbiology</topic><topic>Cross Infection - prevention & control</topic><topic>General aspects</topic><topic>Hospitals</topic><topic>Human bacterial diseases</topic><topic>Human infectious diseases. Experimental studies and models</topic><topic>Humans</topic><topic>Infection Control - methods</topic><topic>Infections</topic><topic>Infectious diseases</topic><topic>Medical practice</topic><topic>Medical sciences</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Patient safety</topic><topic>Ultrasonography</topic><topic>United States</topic><topic>Urinary bladder</topic><topic>Urinary Bladder - diagnostic imaging</topic><topic>Urinary Catheterization - adverse effects</topic><topic>Urinary system involvement in other diseases. Miscellaneous</topic><topic>Urinary tract diseases</topic><topic>Urinary tract infections</topic><topic>Urinary Tract Infections - microbiology</topic><topic>Urinary Tract Infections - prevention & control</topic><topic>Urinary tract. Prostate gland</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Saint, Sanjay</creatorcontrib><creatorcontrib>Kowalski, Christine P.</creatorcontrib><creatorcontrib>Kaufman, Samuel R.</creatorcontrib><creatorcontrib>Hofer, Timothy P.</creatorcontrib><creatorcontrib>Kauffman, Carol A.</creatorcontrib><creatorcontrib>Olmsted, Russell N.</creatorcontrib><creatorcontrib>Forman, Jane</creatorcontrib><creatorcontrib>Banaszak-Holl, Jane</creatorcontrib><creatorcontrib>Damschroder, Laura</creatorcontrib><creatorcontrib>Krein, Sarah L.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Saint, Sanjay</au><au>Kowalski, Christine P.</au><au>Kaufman, Samuel R.</au><au>Hofer, Timothy P.</au><au>Kauffman, Carol A.</au><au>Olmsted, Russell N.</au><au>Forman, Jane</au><au>Banaszak-Holl, Jane</au><au>Damschroder, Laura</au><au>Krein, Sarah L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preventing Hospital-Acquired Urinary Tract Infection in the United States: A National Study</atitle><jtitle>Clinical infectious diseases</jtitle><stitle>Clinical Infectious Diseases</stitle><addtitle>Clinical Infectious Diseases</addtitle><date>2008-01-15</date><risdate>2008</risdate><volume>46</volume><issue>2</issue><spage>243</spage><epage>250</epage><pages>243-250</pages><issn>1058-4838</issn><eissn>1537-6591</eissn><coden>CIDIEL</coden><abstract>Background. Although urinary tract infection (UTI) is the most common hospital-acquired infection in the United States, to our knowledge, no national data exist describing what hospitals in the United States are doing to prevent this patient safety problem. We conducted a national study to examine the current practices used by hospitals to prevent hospital-acquired UTI. Methods. We mailed written surveys to infection control coordinators at a national random sample of nonfederal US hospitals with an intensive care unit and ⩾50 hospital beds (n=600) and to all Veterans Affairs (VA) hospitals (n=119). The survey asked about practices to prevent hospital-acquired UTI and other device-associated infections. Results. The response rate was 72%. Overall, 56% of hospitals did not have a system for monitoring which patients had urinary catheters placed, and 74% did not monitor catheter duration. Thirty percent of hospitals reported regularly using antimicrobial urinary catheters and portable bladder scanners; 14% used condom catheters, and 9% used catheter reminders. VA hospitals were more likely than non-VA hospitals to use portable bladder scanners (49% vs. 29%; P<.001), condom catheters (46% vs. 12%; P<.001), and suprapubic catheters (22% vs. 9%; P<.001); non-VA hospitals were more likely to use antimicrobial urinary catheters (30% vs. 14%; P=.002). Conclusions. Despite the strong link between urinary catheters and subsequent UTI, we found no strategy that appeared to be widely used to prevent hospital-acquired UTI. The most commonly used practices—bladder ultrasound and antimicrobial catheters—were each used in fewer than one-third of hospitals, and urinary catheter reminders, which have proven benefits, were used in <10% of US hospitals.</abstract><cop>Chicago, IL</cop><pub>The University of Chicago Press</pub><pmid>18171256</pmid><doi>10.1086/524662</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Antimicrobials Articles and Commentaries Bacterial diseases Bacterial diseases of the urinary system Biological and medical sciences Catheterization Catheters Catheters, Indwelling - microbiology Condoms Cross Infection - microbiology Cross Infection - prevention & control General aspects Hospitals Human bacterial diseases Human infectious diseases. Experimental studies and models Humans Infection Control - methods Infections Infectious diseases Medical practice Medical sciences Nephrology. Urinary tract diseases Patient safety Ultrasonography United States Urinary bladder Urinary Bladder - diagnostic imaging Urinary Catheterization - adverse effects Urinary system involvement in other diseases. Miscellaneous Urinary tract diseases Urinary tract infections Urinary Tract Infections - microbiology Urinary Tract Infections - prevention & control Urinary tract. Prostate gland Urology |
title | Preventing Hospital-Acquired Urinary Tract Infection in the United States: A National Study |
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