Low adoption by large hospital ICUs of catheter-associated urinary tract infection precautions

Hospital size matters when it comes to intensive care units (ICUs) adopting even the most routine prevention policies for catheter-associated urinary tract infections (CAUTI), according to a new study from researchers at Columbia University School of Nursing, published this month in the American Journal of Infection Control. The study found that large hospitals—those with more than 500 beds —had a 1.5 higher average rate of CAUTI than hospitals with 500 beds or less. Since larger hospitals, particularly teaching hospitals treat patients who are often sicker, the finding that their ICUs have higher incidences of CAUTI, while still a cause of concern, was not unanticipated.

What was puzzling, say the researchers, is that ICUs in larger hospitals – those with the higher rates of CAUTI—were less likely to have implemented a CAUTI prevention policy.

"What we find so baffling is that the very hospitals that have the highest rates of CAUTI are not following the CAUTI preventive guidelines in their intensive care units," says the study's lead author Laurie J. Conway, RN, MS, CIC.

CAUTIs are common and costly occurrences in US hospitals and have been the target of recent national quality initiatives directed at infections acquired in hospital settings. Over the past 30 years, panels of experts in have unanimously recommended taking precautions to minimizing unnecessary urinary catheter use. Among the recommendations are substituting condom catheters for in dwelling catheters, using bladder ultrasound scanners to identify or rule out urinary retention, and using automated reminders, stop orders, or nurse-driven protocols to ensure catheters are discontinued as soon as they are no longer needed.

The researchers conclude that recent federal regulations requiring public reporting of CAUTI rates may serve to refocus attention on CAUTI prevention in ICUs in the United States.

add to favorites email to friend print save as pdf

Related Stories

Nurse staffing, burnout linked to hospital infections

Jul 30, 2012

Nurse burnout leads to higher healthcare-associated infection rates (HAIs) and costs hospitals millions of additional dollars annually, according to a study published in the August issue of the American Journal of Infection Co ...

Catheter chaos: Hospitals lag in preventing common infection

Jan 03, 2008

[B]No consistent strategy for dealing with urinary catheters, or ensuring their removal, means patients and families need to speak up[/B] One in four Americans in the hospital right now has a urinary catheter. One percent of ...

Recommended for you

Fatigue, fear are daily lot of Ebola fighters: experts

4 hours ago

Doctors, nurses and hospital workers fighting the Ebola epidemic in west Africa are struggling with a daily burden of exhaustion, shortage of staff and fear for themselves over the deadly virus, specialists say.

Hong Kong makes Ebola 'contingency' measures

7 hours ago

Hong Kong said Wednesday it was quarantining all people from Guinea, Sierra Leone and Liberia who were showing Ebola-like symptoms on arrival in the city, as fears grow worldwide about the spread of the deadly virus.

User comments