Login to Access Video or Poster Abstract: MP92-02
Sources of Funding: None

Introduction

Catheter associated urinary tract infections (CAUTIs), the most common hospital-acquired infection, increase hospital cost, length of stay, morbidity/mortality and time/wages lost for patients. In an effort to reduce the CAUTI rate, our hospital instituted a Best Practice Alert (BPA) reminder within our inpatient electronic medical record system in 2013. To determine the effect of this BPA, we compared the CAUTI rate and number of urinary catheter days before and after 2013, hypothesizing that this BPA reduced both variables.

Methods

A retrospective review was performed utilizing our institution&[prime]s inpatient database from 2011-2016. All CAUTIs were defined using the 2013 CDC guidelines. Generalized linear mixed modeling was used to estimate the effects of variables of interest on catheter utilization (CU) and CAUTI rates. CU and CAUTI rates were measured using a binomial distribution with a logit link and were also compared between ICU, general adult and general pediatric wards.

Results

Data from 1,102,803 patient days accounting for 227,256 catheter days was evaluated. Between 2011 and 2013, there was a 1.9% decrease per month (p value < 0.0001) in CU rates. Comparing the years of 2013 to 2016, there was less significant decrease at 1.3% per month (p value < 0.0001) in CU rates. Between 2012 and 2016, there was not a significant decrease in CAUTIs despite a decrease in CU rates (0.01% per month, p value 0.846). We also found a lower relative rate in overall CU rate in pediatrics (-3.14, p value < 0.001) as compared to adult units and a higher rate in overall CU rates in the ICU setting (2.04, p value 0.003) as compared to the non-ICU setting.

Conclusions

Our study shows that there is a decrease in CU rates, but no effect on CAUTI rates with the BPA alert. This suggests that factors resulting in CAUTIs are multifactorial and not just limited to length of catheter use. These additional factors may be difficult to control, and perhaps are intrinsic to the patient and their disease process, making some CAUTIs difficult to prevent, despite limiting catheter use. This may result in a plauteau in a hospital&[prime]s overall CAUTI rate, despite following recommended best practices.

Funding

None