Hospital-acquired urinary tract infections comprise 40% of hospital-acquired infections with over 80% of these hospital-acquired urinary tract infections associated with the use of urinary catheters. The process that was used to establish a new hospital protocol using the "IAIMS" (identifying, assessing, implementing, modifying/maintaining, spread/surveillance) model to reduce the incidence of catheter-associated urinary tract infections is described. The example is intended to serve as a framework for the development of protocols to address other hospital-acquired infections.

In today's evolving health care field, outpatient procedures are becoming more commonplace.

To explore selected factors related to the prevention of catheter-associated urinary tract infections (UTIs) in older adults.

Urinary tract infections (UTIs) account for 20-50% of all hospital-acquired infections occurring in the intensive care unit (ICU). In some reports UTI was found to be more frequent than hospital-acquired pneumonia and intravascular device bacteremia, with a greater incidence in developing countries.

The pathogenesis of device-associated infections is related to biofilm bacteria that exhibit distinct characteristics with respect to growth rate, structural features, and protection from host immune mechanisms and antimicrobial agents when compared with planktonic counterparts.

The aim of the present study was to determine the rate of device-associated infection (DAI) and the change in profiles and antimicrobial resistance patterns of the causative microorganisms in a medical-surgical intensive care unit (ICU), as well as to evaluate the effect of a new nationwide hospital infection control program (NHICP), which has been implemented in Turkey.

Urinary Tract Infections (UTIs) account for 24.92% of ICU nosocomial infections investigated. They are associated with increased morbidity and mortality, increased hospital stay and hospital costs, jeopardizing patient safety.

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Healthcare-associated infections (HAIs) are infections that patients acquire while receiving health care for other conditions. These infections cost the US healthcare system billions of dollars each year and lead to the loss of tens of thousands of lives.

CDC recommends strategies for surveillance, prevention, and control of HAIs and antimicrobial resistance wherever health care is provided, including hospitals, ambulatory care facilities, and long-term care facilities. CDC works closely with states to implement these recommendations.

The Prevention Status Reports highlight—for all 50 states and the District of Columbia—the status of a key practice that state health departments can use to reduce HAIs:

State health departments are encouraged to also engage in other practices that will provide actionable HAI data and lead to expanded HAI prevention. These include 1) state health departments validating data sent to CDC’s National Healthcare Safety Network (NHSN), ideally including data on central line-associated bloodstream infections (CLABSIs); catheter-associated urinary tract infections (CAUTIs); and surgical site infections (SSIs); and 2) working with CDC and other partners using NHSN data to target facilities and units most in need of consultation to prevent HAIs and antimicrobial resistance.

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PURPOSE: The aim of this study was to determine device-associated health care-associated infections (DA-HAI) rates, microbiologic profile, bacterial resistance, and length of stay in one intensive care unit (ICU) of a hospital member of the International Nosocomial Infection Control Consortium (INICC) in Poland.

BACKGROUND: Indwelling urinary catheter duration is an important risk factor for catheter-associated urinary tract infections (CAUTIs).

OBJECTIVE: To evaluate two different methods of measuring catheter-associated urinary tract infection (CAUTI) rates in the setting of a quality improvement initiative aimed at reducing device utilization.

OBJECTIVES: To examine the prevalence, natural history, and clinical significance of high postvoid residual (PVR) volume in ambulatory older women.

Changes in reimbursement policies have focused attention on the use of indwelling catheters in the critical care unit as well as their role in hospital-acquired urinary tract infections.

Implementation of an evidence-based prevention program can significantly reduce both the prevalence of indwelling catheterization and the incidence of hospital-acquired catheter-associated urinary tract infection. This article describes the epidemiology and pathophysiology of catheter-associated urinary tract infection, and outlines essential elements of an evidence-based prevention program for the critical care unit.

Written by:
Gray M. Are you the author?
Department of Urology and School of Nursing, University of Virginia, UVA 2nd Floor, Room 2570, PO Box 800422, Charlottesville, VA 22908, USA. .

Reference: AACN Adv Crit Care. 2010 Jul-Sep;21(3):247-57.

PubMed Abstract
PMID: 20683224

BACKGROUND: Many hospitals are increasing surveillance for catheter-associated urinary tract infections, which requires documentation of urinary catheter device-days. However, device-days are usually obtained by chart review or nursing reports. The aim of this study was to demonstrate that chart review can provide accurate urinary catheter data compared with physical inspection of the urinary catheter at the bedside.

Catheter-associated urinary tract infections account for 40% of all nosocomial infections.

A multidisciplinary team implemented evidence-based guidelines and a urinary catheter bundle, focusing on optimizing the use of urinary catheters through continual assessment and prompt catheter removal. Data were obtained on catheter device days, compliance with urinary catheter orders, and computer documentation of continued catheter indications. Results included an overall reduction of 71% in catheter device days and a 56% reduction in catheter use.

Written by:
Andreessen L, Wilde MH, Herendeen P. Are you the author?
Advanced Imaging Associates, Cheektowaga, New York (Dr. Andreessen); and University of Rochester, Rochester, New York (Drs. Wilde and Herendeen), and Golisano Children's Hospital (Dr. Herendeen), Rochester, New York.

Reference: J Nurs Care Qual. 2012 Feb 9. [Epub ahead of print]

PubMed Abstract
PMID: 22327333

BACKGROUND: The formation of bacterial biofilms on urinary catheters is a leading cause of urinary tract infections in intensive care units. Cytobacteriological examination of urine from patients is often misleading, due to the formation of these biofilms. Therefore, characterizing these biofilms and identifying the bacterial species residing on the surface of catheters are of major importance.