A National Implementation Project to Prevent Catheter-Associated Urinary Tract Infection in Nursing Home Residents

JAMA Internal Medicine
Lona ModySanjay Saint

Abstract

Catheter-associated urinary tract infection (UTI) in nursing home residents is a common cause of sepsis, hospital admission, and antimicrobial use leading to colonization with multidrug-resistant organisms. To develop, implement, and evaluate an intervention to reduce catheter-associated UTI. A large-scale prospective implementation project was conducted in community-based nursing homes participating in the Agency for Healthcare Research and Quality Safety Program for Long-Term Care. Nursing homes across 48 states, Washington DC, and Puerto Rico participated. Implementation of the project was conducted between March 1, 2014, and August 31, 2016. The project was implemented over 12-month cohorts and included a technical bundle: catheter removal, aseptic insertion, using regular assessments, training for catheter care, and incontinence care planning, as well as a socioadaptive bundle emphasizing leadership, resident and family engagement, and effective communication. Urinary catheter use and catheter-associated UTI rates using National Healthcare Safety Network definitions were collected. Facility-level urine culture order rates were also obtained. Random-effects negative binomial regression models were used to examine changes in...Continue Reading

Citations

Apr 19, 2018·Journal of the American Geriatrics Society·Robin L P JumpThomas T Yoshikawa
Aug 29, 2017·Journal of the American Geriatrics Society·Jane Banaszak-HollJennifer Meddings
Jul 25, 2019·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Dimitri M DrekonjaBarbara W Trautner
Oct 1, 2019·Annals of Internal Medicine·Jennifer MeddingsSanjay Saint
Oct 1, 2019·Annals of Internal Medicine·Jay Bhatt, Sue Collier
Nov 30, 2019·Journal of the American Geriatrics Society·Susanne Salem-SchatzShira Doron
Dec 11, 2019·Journal of Clinical Nursing·Borghild LøylandKatrin Lindeflaten
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Apr 24, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Barbara W Trautner, Daniel J Morgan
Feb 12, 2019·Open Forum Infectious Diseases·Pranavi Sreeramoju
Nov 15, 2019·Acute and Critical Care·Youngjoon Kang
May 11, 2018·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Sarah L KreinLona Mody
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Sep 5, 2021·International Journal of Urology : Official Journal of the Japanese Urological Association·Satoshi TakahashiToyohiko Watanabe

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