Journal Article

Preventing Hospital-Acquired Urinary Tract Infection in the United States: A National Study

Sanjay Saint, Christine P. Kowalski, Samuel R. Kaufman, Timothy P. Hofer, Carol A. Kauffman, Russell N. Olmsted, Jane Forman, Jane Banaszak-Holl, Laura Damschroder and Sarah L. Krein

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 46, issue 2, pages 243-250
Published in print January 2008 | ISSN: 1058-4838
Published online January 2008 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/524662
Preventing Hospital-Acquired Urinary Tract Infection in the United States: A National Study

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  • Infectious Diseases
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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 ⩾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=.002).

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.

Journal Article.  4142 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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