title: Decreasing nosocomial urinary tract infection in a large academic community hospital.
abstract: Urinary Tract Infection (UTI) is the second most prevalent complication at Lehigh Valley Hospital and Health Network, occurring in 3% of all patients admitted over a 12-month period and contributing to a significant increase in costs. Utilizing data from CareScience's Care Management System, an online decision support tool, in conjunction with hospital laboratory data, and without manual chart review, approximately 20% of all UTIs diagnosed were found to be potentially nosocomial, and were often treated with an expensive broad-spectrum antibiotic. A multidisciplinary hospital committee developed interventions to study and address these findings. The National Nosocomial Infection Surveillance program was initiated on selected units of the hospital; strict catheter placement guidelines and a postoperative urinary retention protocol were developed to minimize catheter use and dwell time, a cost-benefit analysis was conducted, antibiotic use for UTIs was evaluated, and system-wide education was conducted for physicians, residents, and nurses.
authors.affiliation: CareScience, Inc, Philadelphia, PA, USA. bdoyle@carescience.com
authors.forename: B
authors.initials: B
authors.lastname: Doyle
authors.forename: Z
authors.initials: Z
authors.lastname: Mawji
authors.forename: M
authors.initials: M
authors.lastname: Horgan
authors.forename: P
authors.initials: P
authors.lastname: Stillman
authors.forename: A
authors.initials: A
authors.lastname: Rinehart
authors.forename: J
authors.initials: J
authors.lastname: Bailey
authors.forename: E
authors.initials: E
authors.lastname: Mullin
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002408:Catheters, Indwelling / Q000009:adverse effects; D003362:Cost-Benefit Analysis; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D003661:Decision Support Techniques; D017723:Drug Utilization Review; D006764:Hospitals, Community; D006785:Hospitals, University; D006801:Humans; D017053:Infection Control / Q000458:organization & administration*; D007902:Length of Stay; D009017:Morbidity; D017063:Outcome Assessment, Health Care / Q000458:organization & administration*; D010348:Patient Care Team / Q000458:organization & administration; D010414:Pennsylvania / Q000453:epidemiology; D010564:Personnel, Hospital / Q000193:education; D017410:Practice Guidelines as Topic; D015995:Prevalence; D011367:Professional Staff Committees / Q000458:organization & administration; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D017749:Total Quality Management / Q000458:organization & administration*; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents