Catheter-Associated Urinary Tract Infections
Catheter-associated urinary tract infections routinely top the list of most commonly reported device-associated hospital-acquired infections. Prolonged use of the urinary catheter represents an important risk factor for developing such an infection. Urinary catheters may be necessary for conditions such as an inability to urinate. They are also commonly used to measure urine output when a patient is critically ill.
Medical caregivers at Cedars-Sinai take many precautions to prevent these infections, including:
- Properly cleaning hands before putting in the catheter
- Carefully avoiding contamination of the drainage spigot when emptying
- Always positioning tubing and bags below bladder level, off the floor
- Checking the system for closed connections and obstructions/kinks
- Ensuring closed and intact seals, and replacing the complete system if a seal is broken or otherwise nonaseptic
- Removing the catheter when no longer needed
By carefully monitoring the rate of central line infections, Cedars-Sinai lives up to its commitment to improving the quality of care for patients.
As a legal requirement, California hospitals report these infections to the California Department of Public Health and the National Healthcare Safety Network, part of the Centers for Disease Control and Prevention. The California department adjusts the data for risk factors according to the federal network's protocols. The risk adjustment is required, and uses national data to compare the actual number of infections to the expected number, based on the age and health of the surgery patients.
The chart below shows the rate of catheter-associated urinary tract infections that occurred in patients in the Adult Intensive Care Units at Cedars-Sinai vs. the expected number.
The standardized infection ratio is a summary measure used to track infections at a national, state or local level over time. The ratio compares the actual number of infections reported to a predicted number, adjusting for risk factors significantly associated with differences in infection incidence. A lower number is better.
The National Healthcare Safety Network instituted the new 2015 baseline time period for the number predicted calculation. The data included in the 2015 baseline will serve as a new reference point for comparing progress. The federal Centers for Disease Control and Prevention expects that hospital standardized infection ratios will increase and shift closer to 1. This shift reflects nationwide improvement in infection prevention from the previous baseline time period.