According to the Centers for Disease Control and Prevention (CDC), urinary tract infections (UTIs) are the most common healthcare-acquired infection, accounting for nearly 40 percent of all nosocomial infections. This has become a major issue for hospitals since the Centers for Medicare and Medicaid Services (CMS) stopped reimbursing hospitals for hospital-acquired UTIs in October 2008. To help hospitals reduce UTI incidence, VHA Inc., the national healthcare alliance, brought 21 Pennsylvania hospitals together in September 2008 to share best practices around UTI prevention and accelerate the ability of hospitals to implement prevention strategies. The participating hospitals have reduced symptomatic urinary tract infections by 32 percent and seen a 3.6 percent drop in the number of day’s patients use catheters while hospitalized, a major cause of infections.
“UTIs are costly and can complicate a patient’s condition and/or outcome,” said Marilyn Rudolph, RN, BSN, MBA, vice president of performance improvement at the Pennsylvania office of VHA. “Through comprehensive data review and coaching calls that allow participating hospitals to share information and collaborate, VHA is helping its member hospitals provide better patient care.”
One hospital participating in the VHA UTI program is Jefferson Regional Medical Center in Pittsburgh. The medical center was already exploring comprehensive measures for reducing UTI incidence in its patients and joined the VHA program to enhance its efforts. The hospital has developed and implemented more than 20 action items to help decrease UTI rates including:
· A physician order sheet that addresses criteria for Foley catheter use on a daily basis
· A protocol and competency for urinalysis, and culture and sensitivity collection
· A pamphlet for patients and family’s addressing the care of and indication for a Foley catheter
· Hospital-wide education and mandatory competencies concerning Foley care and insertion
“Every UTI prevented is a phenomenal outcome for our patients and a financial success for the hospital,” said Nancy Winkleblech, RN, BSN, MS, ET, manager of the respiratory care unit at Jefferson Regional. “We are on target to decrease the number of catheter-associated UTIs by 50 percent this fiscal year, and have reduced catheter use device days by 15 percent.”
