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Fluids & Electrolytes
Researchers have found that fewer than 10% of hospitals use a strategy proven to reduce rates of catheter-related urinary tract infections (UTIs): a daily reminder for a patient's primary care provider to consider removing urinary catheters, which are strongly associated with UTIs.
Researchers mailed a survey to 119 Veterans Administration (VA) hospitals and 600 other hospitals with an intensive-care unit and 50 or more hospital beds. Survey questions explored practices to prevent hospital-acquired UTIs and other device-associated infections.
In all, 56% of responding hospitals had no system for monitoring which patients had urinary catheters, and 74% of hospitals didn't monitor the duration of catheter placement. Nearly one-third of hospitals didn't track UTI rates in patients.
Various practices that can be used to prevent UTIs were underutilized by the facilities surveyed, as follows:
* antimicrobial urinary catheters and portable bladder scanners, 30%
* condom catheters, 14%
* catheter removal reminders, 9%.
Despite having a standardized electronic medical order entry system, VA hospitals were no more likely than non-VA facilities to use reminders to prompt removal of unneeded catheters.
Researchers conclude that despite the clear link between urinary catheters and UTIs, no strategy has been widely adopted to address the problem. They urge hospitalized patients with urinary catheters to ask their primary care provider or nurse every day if they still need it.
Saint S, et al., Preventing hospital-acquired urinary tract infections in the United States: A national study, Clinical Infectious Diseases, January 15, 2008.
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