Do Best Practice Alerts Reduce CAUTIs? The Influence of an Electronic Medical Record Embedded Best Practice Alert on Rate of Hospital Acquired Catheter Associated Urinary Tract Infections.

To understand if an electronic medical record embedded best practice alert decreased our hospital's Catheter associated urinary tract infections (CAUTIs) and catheter utilization (CU) rates.

Data from our inpatient prospective CAUTI database, spanning 2011 to 2016, was utilized for our analysis with the BPA starting in 2013. Using generalized linear models we compared the CU and CAUTI rates between pre- and post-BPA periods in different patient sub-populations.

We identified no decrease in the CU rate and no effect on the CAUTI rates as a result of the BPA. However, there was an increase in CAUTI rates in our adult ICU population from 0.2 to 1.8 CAUTIs per 1,000 catheter days (p<0.01) despite a significant decrease in CU rate within this population after the BPA (Pre-BPA OR 0.93 versus Post-BPA OR 0.89; p<0.01). In contrast, our non-ICU adult population had a decrease in CAUTI rate from 2.8 to 1.7 CAUTIs per 1,000 catheter days (p<0.01) despite no significant decrease after the BPA (Pre-BPA OR 0.90 versus Post-BPA OR 0.95; p<0.1).

CAUTI rates are exceedingly low, with or without the use of a BPA. Such an alert appears to have limited success in lowering CU rates in populations where catheter use is already low and may not always lead to an improvement in CAUTI rates as there appears to be some populations that may be more prone to CAUTI development secondary to possible intrinsic or co-morbid conditions.

Urology. 2020 Apr 05 [Epub ahead of print]

Colette M Gnade, Chaorong Wu, Patrick Ten Eyck, Laurie Leder, Douglas Storm

University of Iowa Hospitals and Clinics, Department of Obstetrics and Gynecology. Electronic address: ., University of Iowa Institute for Clinical and Translational Science., University of Iowa Department of Epidemiology., University of Iowa Hospitals and Clinics, Department of Urology. Electronic address: .

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