Prevention of Nosocomial Catheter-Associated Urinary Tract Infections Through Computerized Feedback to Physicians and a Nurse-Directed Protocol.

Catheter-associated urinary tract infections (CAUTIs) represent the most common nosocomial infection. The authors' baseline rate of CAUTI for general medical service was elevated at 36 per 1000 catheter-days. The medical literature has consistently linked inappropriate catheter use with the development of CAUTI. The baseline data also revealed a high rate of inappropriate use of indwelling urinary catheters. Using the dual modalities of technology through prompts in the computerized order/entry system and handheld bladder scanners, as well as in combination with staff education and nurse empowerment, the authors were successful in reducing the use and duration of urinary catheters as well as the incidence of CAUTI. In subsequent data collection cycles over the following 2 years, 81% reduction in device use and a 73% reduction in the clinical end point of nosocomial CAUTI (36/1000 catheter-days to 11/1000 catheter-days; P < .001) was demonstrated.

American journal of medical quality : the official journal of the American College of Medical Quality. 0000 Jan [Epub]

Jeffrey Topal, Sandra Conklin, Karen Camp, Victor Morris, Thomas Balcezak, Peter Herbert

1 Dr Topal is a physician specialist in the Department of Pharmacy Services., 2 Ms Conklin is a clinical effectiveness specialist., 3 Ms Camp is the administrative director of patient services., 4 Dr Morris is the assistant chief of staff., 5 Dr Balcezak is the administrative director of performance management., 6 Dr Herbert is the chief of staff at Yale-New Haven Hospital, New Haven, Connecticut.