Decreasing Catheter-Associated Urinary Tract Infections in the Neurological Intensive Care Unit: One Unit’s Success

Abstract

BACKGROUND Catheter-associated urinary tract infections are preventable adverse outcomes that increase hospital morbidity, mortality, and costs. These infections are particularly prevalent in intensive care units. OBJECTIVES To describe the success of an 18-bed neurological intensive care unit in using several nurse-implemented strategies that reduced the number of catheter-associated urinary tract infections. METHODS A prospective, interventional design with application of evidence-based practices to reduce catheter-associated urinary tract infections was used. RESULTS Before implementation of the strategies, 40 catheter-associated urinary tract infections were reported for 2012 and 38 for 2013. The standardized infection ratio was 2.04 for 2012 (95% CI, 1.456–2.775) and 2.34 (95% CI, 1.522–3.312) for 2013. After implementation of the strategies, significantly fewer catheter-associated urinary tract infections were reported. In 2014, a total of 15 infections were reported, and the standardized infection ratio was less than 1.0 (95% CI, 0.685–1.900). CONCLUSIONS Application of current evidence-based practices resulted in a substantial decrease in the number of catheter-associated urinary tract infections and a lower standardized infection ratio. These findings support current recommendations for “bundling” to maximize outcomes.