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The evolution of catheter-associated urinary tract infection (CAUTI): Is it time for more inclusive metrics?

Published online by Cambridge University Press:  27 March 2019

Sonali D. Advani Open the ORCID record for Sonali D. Advani [Opens in a new window]  and
Mohamad G. Fakih Open the ORCID record for Mohamad G. Fakih [Opens in a new window]
Sonali D. Advani*
Affiliation:
Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut
Mohamad G. Fakih
Affiliation:
Care Excellence, Ascension Health, St Louis, Missouri Wayne State University School of Medicine, Detroit, Michigan
*
Author for correspondence: Sonali D. Advani, Email: sonali.advani@yale.edu
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Abstract

Catheter-associated urinary tract infection (CAUTI) has long been considered a preventable healthcare-associated infection. Many federal agencies, the Centers for Medicare and Medicaid Services (CMS), and public and private healthcare organizations have implemented strategies aimed at preventing CAUTIs. To monitor progress in CAUTI prevention, the National Healthcare Safety Network (NHSN) CAUTI metric has been adopted nationally as the primary outcome measure and has been refined over the past decades. However, this surveillance metric may underestimate infectious and noninfectious catheter harm. We suggest evolving to more inclusive performance metrics to better reflect quality improvement efforts underway in hospitals. The standardized device utilization ratio (SUR) provides a good surrogate for preventable catheter harm. On the other hand, a population-based metric that combines both standardized infection ratio (SIR) and SUR would address both infectious and noninfectious harm, while adjusting for population risk. Finally, electronically captured catheter-associated bacteriuria may contribute essential information on local testing stewardship.

Type
Review
Information
Infection Control & Hospital Epidemiology , Volume 40 , Issue 6 , June 2019 , pp. 681 - 685
Copyright
© 2019 by The Society for Healthcare Epidemiology of America. All rights reserved. 

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