title: Prevention of nosocomial catheter-associated urinary tract infections through computerized feedback to physicians and a nurse-directed protocol.
abstract: 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.
authors.affiliation: Department of Pharmacy Services, Yale-New Haven Hospital, New Haven, Connecticut 06504, USA. jeffrey.topal@ynhh.org
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Topal
authors.forename: Sandra
authors.initials: S
authors.lastname: Conklin
authors.forename: Karen
authors.initials: K
authors.lastname: Camp
authors.forename: Victor
authors.initials: V
authors.lastname: Morris
authors.forename: Thomas
authors.initials: T
authors.lastname: Balcezak
authors.forename: Peter
authors.initials: P
authors.lastname: Herbert
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002408:Catheters, Indwelling / Q000009:adverse effects*; D015331:Cohort Studies; D003237:Connecticut; D003428:Cross Infection / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D008297:Male; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000379:methods*; D014546:Urinary Catheterization / Q000009:adverse effects*; D014552:Urinary Tract Infections / Q000209:etiology / Q000517:prevention & control*