title: Preventing hospital-acquired urinary tract infection in the United States: a national study.
abstract: BACKGROUND
  Although urinary tract infection (UTI) is the most common hospital-acquired infection in the United States, to our knowledge, no national data exist describing what hospitals in the United States are doing to prevent this patient safety problem. We conducted a national study to examine the current practices used by hospitals to prevent hospital-acquired UTI.
  
  
  METHODS
  We mailed written surveys to infection control coordinators at a national random sample of nonfederal US hospitals with an intensive care unit and >or=50 hospital beds (n=600) and to all Veterans Affairs (VA) hospitals (n=119). The survey asked about practices to prevent hospital-acquired UTI and other device-associated infections.
  
  
  RESULTS
  The response rate was 72%. Overall, 56% of hospitals did not have a system for monitoring which patients had urinary catheters placed, and 74% did not monitor catheter duration. Thirty percent of hospitals reported regularly using antimicrobial urinary catheters and portable bladder scanners; 14% used condom catheters, and 9% used catheter reminders. VA hospitals were more likely than non-VA hospitals to use portable bladder scanners (49% vs. 29%; P=.001), condom catheters (46% vs. 12%; P=.001), and suprapubic catheters (22% vs. 9%; P=.001); non-VA hospitals were more likely to use antimicrobial urinary catheters (30% vs. 14%; P=.001).
  
  
  CONCLUSIONS
  Despite the strong link between urinary catheters and subsequent UTI, we found no strategy that appeared to be widely used to prevent hospital-acquired UTI. The most commonly used practices--bladder ultrasound and antimicrobial catheters--were each used in fewer than one-third of hospitals, and urinary catheter reminders, which have proven benefits, were used in <10% of US hospitals.
authors.affiliation: Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA. saint@med.umich.edu
authors.forename: Sanjay
authors.initials: S
authors.lastname: Saint
authors.forename: Christine P
authors.initials: CP
authors.lastname: Kowalski
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Kaufman
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Hofer
authors.forename: Carol A
authors.initials: CA
authors.lastname: Kauffman
authors.forename: Russell N
authors.initials: RN
authors.lastname: Olmsted
authors.forename: Jane
authors.initials: J
authors.lastname: Forman
authors.forename: Jane
authors.initials: J
authors.lastname: Banaszak-Holl
authors.forename: Laura
authors.initials: L
authors.lastname: Damschroder
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Krein
mesh_terms: D002408:Catheters, Indwelling / Q000382:microbiology; D003428:Cross Infection / Q000382:microbiology / Q000517:prevention & control*; D006761:Hospitals; D006801:Humans; D017053:Infection Control / Q000379:methods*; D014463:Ultrasonography; D014481:United States; D001743:Urinary Bladder / Q000000981:diagnostic imaging; D014546:Urinary Catheterization / Q000009:adverse effects; D014552:Urinary Tract Infections / Q000382:microbiology / Q000517:prevention & control*