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Beyond Infection: Device Utilization Ratio as a Performance Measure for Urinary Catheter Harm

Published online by Cambridge University Press:  27 November 2015

Mohamad G. Fakih ,
Carolyn V. Gould ,
Barbara W. Trautner ,
Jennifer Meddings ,
Russell N. Olmsted ,
Sarah L. Krein  and
Sanjay Saint
Mohamad G. Fakih*
Affiliation:
St. John Hospital and Medical Center, Detroit, Michigan Wayne State University School of Medicine, Detroit, Michigan
Carolyn V. Gould
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Barbara W. Trautner
Affiliation:
Houston VA Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas Section of Infectious Diseases, Department of Medicine and Department of Surgery, Baylor College of Medicine, Houston, Texas
Jennifer Meddings
Affiliation:
Department of Internal Medicine, Division of General Medicine, University of Michigan Medical School, Ann Arbor, Michigan
Russell N. Olmsted
Affiliation:
Infection Prevention and Control, Unified Clinical Organization, Trinity Health, Livonia, Michigan
Sarah L. Krein
Affiliation:
VA Ann Arbor Healthcare System, Ann Arbor, Michigan
Sanjay Saint
Affiliation:
VA Ann Arbor Healthcare System, Ann Arbor, Michigan Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan
*
Address correspondence to Mohamad G. Fakih, MD, MPH, Medical Director, Infection Prevention and Control, St. John Hospital and Medical Center, 19251 Mack Ave, Suite 190, Grosse Pointe Woods, MI 48236 (Mohamad.Fakih@stjohn.org).
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Abstract

Catheter-associated urinary tract infection (CAUTI) is considered a reasonably preventable event in the hospital setting, and it has been included in the US Department of Health and Human Services National Action Plan to Prevent Healthcare-Associated Infections. While multiple definitions for measuring CAUTI exist, each has important limitations, and understanding these limitations is important to both clinical practice and policy decisions. The National Healthcare Safety Network (NHSN) surveillance definition, the most frequently used outcome measure for CAUTI prevention efforts, has limited clinical correlation and does not necessarily reflect noninfectious harms related to the catheter. We advocate use of the device utilization ratio (DUR) as an additional performance measure for potential urinary catheter harm. The DUR is patient-centered and objective and is currently captured as part of NHSN reporting. Furthermore, these data are readily obtainable from electronic medical records. The DUR also provides a more direct reflection of improvement efforts focused on reducing inappropriate urinary catheter use.

Infect. Control Hosp. Epidemiol. 2016;37(3):327–333

Type
Review Article
Information
Infection Control & Hospital Epidemiology , Volume 37 , Issue 3 , March 2016 , pp. 327 - 333
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

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