Abstract

Targeted Reminders: Effect on Urinary Catheter Associated Infections in a Community Hospital

Ogie Umasabor-Bubu, MBBS MPH CPH CIC1, Baoying Lin-Chen, MPH1, Eman Wahab, RN CNOR MSNEd1, John Vernaleo, MD2 and Ronald Budiman, BS, CIC1
(1)Interfaith Medical Center, Brooklyn, NY, (2)Interfaith Medical Center, Brooklyn

APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)

Catheter associated urinary tract infections (CAUTIs) are among the most common type of health care associated infections (HAIs) accounting for about 30% of infections in acute care facilities. Urinary tract infections(UTI) are infections involving any part of the urinary system and indwelling urinary catheters are usually potential channels for infections. Our facility is an acute care setting with population served comprising poor and medically underserved persons with high risk of infections. The objective of this study was to evaluate the potential effects of targeted verbal reminders with frontline staff on urinary catheter associated infection rates. All adult patients admitted into intensive and non-intensive units, and had Foley urinary catheter insertion from July to December 2016 were included in our study. We used the preceding six months (January to June 2016) to establish baseline data. The Infection Preventionist begun a 48-hour interval intense verbal campaign of engaging physicians and nurses on Foley necessity and exploring “alternatives” such as condom catheters and urinals. The primary variable was hospital-acquired CAUTI, which is a UTI in an admitted patient with Foley in place for greater than two calendar days on the date infection criteria was met . Data were derived from the National Healthcare Safety Network (NHSN) Surveillance from the Centers for Disease Control and Prevention (CDC), which is a widely, used HAI tracking system for hospitals in the United States. NHSN utilizes the standardized infection ratio (SIR), which is a statistic used to track HAI over time and compares the actual number of HAIs to the number of infections predicted using regression models for that facility. A baseline SIR of 3.158 with a p-value of 0.0285 (95% CI 1.157, 7.001) was established prior to intervention, which was statistically significant. Following intervention (July 2016), we noticed a downward trend and at the end of year, our SIR for second half was 0.815 with a p-value of 0.9460 (95% CI 0.041, 4.019), which was not statistically significant. The findings suggest that targeted communication with frontline staff in urinary catheter necessity and providing alternatives can significantly lead to a decrease in CAUTIs in acute care settings.

Communication and informatics Epidemiology Implementation of health education strategies, interventions and programs Public health or related nursing