title: Comparing Catheter-Associated Urinary Tract Infection Prevention Programs Between Veterans Affairs Nursing Homes and Non-Veterans Affairs Nursing Homes.
abstract: OBJECTIVE The impact of healthcare system integration on infection prevention programs is unknown. Using catheter-associated urinary tract infection (CAUTI) prevention as an example, we hypothesize that US Department of Veterans Affairs (VA) nursing homes have a more robust infection prevention infrastructure due to integration and centralization compared with non-VA nursing homes. SETTING VA and non-VA nursing homes participating in the AHRQ Safety Program for Long-Term Care collaborative. METHODS Nursing homes provided baseline information about their infection prevention programs to assess strengths and gaps related to CAUTI prevention via a needs assessment questionnaire. RESULTS A total of 353 of 494 nursing homes from 41 states (71%; 47 VA and 306 non-VA facilities) responded. VA nursing homes reported more hours per week devoted to infection prevention-related activities (31 vs 12 hours; P<.001) and were more likely to have committees that reviewed healthcare-associated infections. Compared with non-VA facilities, a higher percentage of VA nursing homes reported tracking CAUTI rates (94% vs 66%; P<.001), sharing CAUTI data with leadership (94% vs 70%; P=.014) and with nursing personnel (85% vs 56%, P=.003). However, fewer VA nursing homes reported having policies for appropriate catheter use (64% vs 81%; P=.004) and catheter insertion (83% vs 94%; P=.004). CONCLUSIONS Among nursing homes participating in an AHRQ-funded collaborative, VA and non-VA nursing homes differed in their approach to CAUTI prevention. Best practices from both settings should be applied universally to create an optimal infection prevention program within emerging integrated healthcare systems. Infect Control Hosp Epidemiol 2017;38:287-293.
authors.affiliation: 1Geriatric Research Education and Clinical Center Ann Arbor Veterans Affairs Healthcare System,Ann Arbor,Michigan.
authors.forename: Lona
authors.initials: L
authors.lastname: Mody
authors.affiliation: 2Center for Clinical Management Research Ann Arbor Veterans Affairs Healthcare System,Ann Arbor,Michigan.
authors.forename: M Todd
authors.initials: MT
authors.lastname: Greene
authors.affiliation: 2Center for Clinical Management Research Ann Arbor Veterans Affairs Healthcare System,Ann Arbor,Michigan.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Saint
authors.affiliation: 3Medicine Service,Ann Arbor Veterans Affairs Healthcare System,Ann Arbor,Michigan.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Meddings
authors.affiliation: 9The Center for Innovations in Quality,Effectiveness, and Safety (IQuESt),Michael E. DeBakey Veterans Affairs Medical Center,Houston,Texas.
authors.forename: Barbara W
authors.initials: BW
authors.lastname: Trautner
authors.affiliation: 11Department of Medicine,University of Colorado School of Medicine,Aurora,Colorado.
authors.forename: Heidi L
authors.initials: HL
authors.lastname: Wald
authors.affiliation: 12School of Medicine and Public Health,University of Wisconsin,Madison,Wisconsin.
authors.forename: Christopher
authors.initials: C
authors.lastname: Crnich
authors.affiliation: 8Institute of Gerontology,University of Michigan Medical School,Ann Arbor,Michigan.
authors.forename: Jane
authors.initials: J
authors.lastname: Banaszak-Holl
authors.affiliation: 5Division of Geriatric and Palliative Care Medicine,University of Michigan Medical School,Ann Arbor,Michigan.
authors.forename: Sara E
authors.initials: SE
authors.lastname: McNamara
authors.affiliation: 4Veterans Affairs National Center for Patient Safety,Department of Veterans Affairs,Ann Arbor,Michigan.
authors.forename: Beth J
authors.initials: BJ
authors.lastname: King
authors.affiliation: 1Geriatric Research Education and Clinical Center Ann Arbor Veterans Affairs Healthcare System,Ann Arbor,Michigan.
authors.forename: Robert
authors.initials: R
authors.lastname: Hogikyan
authors.affiliation: 15Health Research and Educational Trust,American Hospital Association, Chicago,Illinois.
authors.forename: Barbara S
authors.initials: BS
authors.lastname: Edson
authors.affiliation: 2Center for Clinical Management Research Ann Arbor Veterans Affairs Healthcare System,Ann Arbor,Michigan.
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Krein
mesh_terms: D055499:Catheter-Related Infections / Q000517:prevention & control*; D003428:Cross Infection / Q000517:prevention & control*; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007857:Leadership; D016015:Logistic Models; D015999:Multivariate Analysis; D009735:Nursing Homes / Q000592:standards* / Q000706:statistics & numerical data; D009740:Nursing Staff; D017410:Practice Guidelines as Topic; D011216:Practice Management, Medical; D011795:Surveys and Questionnaires; D014481:United States; D014493:United States Department of Veterans Affairs; D014552:Urinary Tract Infections / Q000517:prevention & control*